There’s (not) an app for that

Last updated on: October 9, 2014 at 10:28 pm by Jane the Actuary

There’s (not) an app for that 2014-10-09T22:28:00-06:00 Jane the Actuary

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but I wish there were.

Simultaneously I’m irritated by the massive increase in the employee share of the healthcare premiums at work (68% for us, 95% for one of my colleagues), and trying to push back on a medical charge from this summer.

The premium increases are particularly irritating because the company likes to promote itself as an expert in advising its clients on how to reduce their healthcare expenses. But apparently (I can say this because this is an anonymous blog) we don’t actually know what we’re talking about.

The medical charge: that’s especially maddening. Earlier this summer (I didn’t blog about it at the time), we were at the marina, an hour and 15 minutes from home, when my son got a splinter from running around barefoot on the dock. This was a pretty big splinter, and straight in, and, even with our first aid kit, we didn’t think we’d be able to get it out, so we set out looking for an urgent treatment center, and were referred to a local hospital which we were told had an urgent care center. Turned out it was an ER which would also provide “urgent care” treatment — but in our case, they said right away, “anything with broken skin is classified as ER.”

And this turned out to be a frickin’ huge ER bill — well, in the grand scheme of things, not as bad as a broken bone might have been, but still: more expensive to remove a splinter than the charge we had earlier for stitches in my other son’s forehead, even though, in both cases, there were the usual insurance adjustments.

And yet — what could we have done? Well, besides go to the drugstore and load up on first aid supplies, antiseptic, etc.? It was Saturday evening. We were pretty much stuck. True, there were two hospitals equally distant — we could have chosen the other one — but we thought we were going to an urgent care center. And how could we have known which had the better price?

So this is where insurance companies could actually help themselves and their customers save money: I want an app. I want an app that allows me to provide my location and the basic medical issue (“splitnter” or “stitches”), and be told where to go for the lowest price. How hard can that be? The insurance company knows what the hospitals are going to charge because these are contracted rates. Sure, there’s no guarantee that the splinter-removal isn’t somehow more complicated than expected, but it’s still at least a bit of an aid. They could just as easily add in the opening hours, too, right? I suppose they could throw in the ability to chat or facetime with a nurse who could talk you through a home remedy, too.

And in light of the reports of “surprise” out-of-network charges, I’d add another piece to the puzzle. If I’m going to an in-network hospital, I want to know that the doctors on call there are all in-network. If my insurance provider can’t give me that assurance, I want them to at least ask hospitals and providers whether they are willing to commit to not pulling in out-of-network providers unexpectedly — and I want to be given that information so I can comparison-shop properly.

Of course, the problem is that, in our employer-provided model, how are insurance companies going to market this great app to their prospective customers? The best they could do is pitch their product to the employer selecting the plans to provide to their employees — but is a plan sponsor really going to pick a plan based on the promise of lower employee out-of-pocket costs?

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