Transparency Pricing Presentation

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Tired of not knowing how much a medical procedure is going to cost you? Learn how to empower yourself.

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Transparency Pricing Presentation

  1. 1. Consumer Tools & TechnologyDefinition of Consumerism:The protection of the rights and interestsof consumers, especially with regard toprice, quality and safety
  2. 2. Pricing TransparencyHow easy is it to compare prices for the following items:1. Car2. Auto Body Work3. Television4. Computer5. House
  3. 3. Pricing TransparencyHow easy is it to compare prices for the following items:1. Well Baby Delivery2. Cat Scan3. Colonoscopy4. Knee Surgery5. Hip Replacement
  4. 4. Issues Surrounding Pricing Transparency1. High degree of price variability even within a network2. Lack of integration in most healthcare delivery systems3. Patients don’t want to be engaged in insurance.
  5. 5. Price-Transparency Software
  6. 6. Arthroscopic Knee Surgery Market Analysis $4,309$4,500$4,000 $3,095$3,500$3,000 Mercy Philadelphia Hospital$2,500 Thomas Jefferson University Hospital $1,684 The Surgery Center of Pennsylvania$2,000$1,500$1,000 $500 $0 In-Network Allowed Amount Total savings of $2,031 could be achieved between high cost and low cost service providers.
  7. 7. Colonoscopy Market Analysis $2,408$2,500$2,000$1,500 $1,155 Mercy Philadelphia Hospital Thomas Jefferson University Hospital Main Line Endoscopy$1,000 $413 $500 $0 In-Network Allowed Amount Total savings of $1,995 could be achieved between high cost and low cost service providers.
  8. 8. MRI Lumbar Spine Market Analysis $2,728$3,000$2,500$2,000 $1,548 Mercy Philadelphia Hospital Temple University$1,500 Main Health Imaging$1,000 $580 $500 $0 In-Network Allowed Amount Total savings of $2,148 could be achieved between high cost and low cost service providers.
  9. 9. Consumer AdvocateConsumer Advocate can facilitate the process by: 1. Accessible for initial contact 2. Making the complex simple 3. Handle of the “behind the scenes work” 4. Educate the consumer on quality and price
  10. 10. Pricing Information in User Friendly Format
  11. 11. Case Study• 3,000 employee company• Claims analysis for a 12 month period• Observed many of the companies costs were inconsumer actionable categories such as imaging,endoscopies and outpatient surgery• By providing pricing data to members in an easy tounderstand format, savings results for a 12 month periodwere as follows: Cost Category Annualized Cost Savings % Annual Savings Medical $18,019,363 13% $2,323,872

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