A good health care plan is hard to find; it should be able to both provide quality care and avoid unnecessary medical costs. It can be easy to tell if you are getting the care that you need, but it’s harder to figure out what unnecessary healthcare costs are creeping into your insurance bills.
There are many different ways that unnecessary costs can add up in your insurance. Preventative measures can drastically decrease these costs. Helping customers to maintain control of their chronic diseases keeps patients out of hospitals and the emergency room. But when patients do have to be admitted to the hospital, readmission soon after discharge can mean that the doctor didn’t correctly coordinate the patient’s discharge or that appropriate care wasn’t provided during their stay. Other unnecessary costs can include: inappropriate use of antibiotics leading to ineffective drugs and antibiotic-resistant strains of bacteria, unnecessary x-rays, CT scans, or MRIs for lower back pain that will clear up on it’s own, or overuse of invasive heart procedures when problems could be controlled with lifestyle changes and drugs.
Healthcare Plan Rankings
So, how well does your health care plan stack up against the others in avoiding costs like the ones mentioned above? ConsumerReports.org gathered data on private health-insurance plans from the National Committee of Quality Assurance to create a ranking of all the plans by state. Their full list of rankings and scores can be found on their website.
ConsumerReports.org found that Kaiser Foundation Health Plans, Inc. was the most successful with sixty-seven percent of their plans having a high enough score to be considered as “avoiding overuse.” The rest of the private insurance plans ranked as follows:
Kaiser Foundation Health Plans, Inc. 67%
Blue Cross and Blue Shield Association 27%
CIGNA HealthCare, Inc. 21%
Coventry Health Care, Inc. 17%
Aetna Health, Inc. 8%
UnitedHealthcare Corporation 6%
Health Net, Inc. 0%
Humana, Inc. 0%
Wellpoint, Inc. 0%
Deciding on a Plan
When deciding on a private health-insurance plan, keep these unnecessary costs in mind. In comparing the gathered data, health maintenance organizations (HMOs), plans that only cover in-network providers and generally require members to get referrals from primary care doctors, scored better than preferred provider organizations (PPOs), in which members can see providers that are out their network, but at high costs.
Your insurance plan’s assistance in avoiding unnecessary health care costs is important, but don’t forget to also look into the insurance plan’s customer satisfaction, treatment options, and accreditation before making your decision.
For more on health care plans:
Two Types of Health Insurance and How to Pick the Right Insurance Plan for You
Important Questions to Ask Your Health Insurance Provider