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Steer to High Quality for Lower Cost


Steer to High Quality for Lower Cost

This month we’re talking about immediate impact. It’s more essential than ever for companies to adapt to the ever changing regulatory and healthcare industry. Without taking control, you won’t be able to plan for what is usually your client’s second or third-largest individual expense – healthcare. As CFO magazine noted, nearly all large companies operate as health care businesses [1] when you consider how much they spend. Companies like GM spend more on healthcare than steel, and Starbucks spends more on health care benefits than coffee beans.

One of the incredible discoveries when navigating care for your clients – unlike nearly every product – is recognizing that quality care often comes at a lower cost. For example, using health care quality scores like Hospital safety grades [2] helps clients seek better care. Leapfrog helps to standardize reporting about surgeries, environment, and provider issues to help you navigate your client’s care to the institutions that have better outcomes. Review the site to learn how hospitals manage safety and rank locally. While these measures are largely self-reported, metrics like these still help advisors glean insight about hospitals and providers in their area to help their clients find quality care. 

Be careful of methodologies as well. Make sure to check any resource to understand how their stated methodology works and where recommendations derive from. What are the metrics they use to rank providers? What data sources? How large of a sample size are they using? Does it consider re-admission for patients? While some sources may see those as separate medical instances, in evaluating the true cost of care advisors have to consider follow up costs. Examples include resources like Healthcare Bluebook [3]  that compiles data across medical databases, to navigate cost of care against quality of physicians. That data goes beyond self-reported metrics, to better determine true cost of care and evaluate against a wider number of providers.

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This month we’ll also be introducing more content about reference based pricing, and technical concepts like J-codes used in medical billing to help your clients save. Data newly released by providers due to new laws put into effect since 2019, is helping advisors and employers better plan and navigate care options. And the insurer and hospital data released has been enlightening. We already know that procedures can vary widely, costing 5x as much for the exact same procedure [4], at the same hospital.

Learning about the history of medical providers in your area, compiling data on cost of care, and understanding quality scores helps you take control by helping advise where your clients choose to receive service. Poor providers means more complications and potential issues. Seek better quality, at lower cost. A quick and immediate fix to help your business.

[1] Chase, D. (2017, November 7). You Run a Health-Care Business Whether You Like It or Not. CFO. July 2021.

[2] Leapfrog, Hospital Safety Grade. Home. (n.d.). July 2021.

[3] Hospital Quality Awards: An Objective Comparison. Healthcare Bluebook. (n.d.). July 2021

[4] Sumida, S. L. and N. (2021, March 11). Hospitals lift curtain on prices, revealing giant swings in pricing by procedure. Healthcare Dive. July 2021..