Would you consider changing your doctor(s) if you had the option and knew you would receive higher-quality care that would be friendly to your budget?
Last month we explained how quality doesn’t have to cost more when your health benefits include services and tools that help you save, not sacrifice. This month we want to talk about another way workers and their employers can save on healthcare costs and get the best of the best when it comes to doctors and medical facilities.
You might have heard of narrow networks, but it’s more accurate to call them focused networks because they are focused on providing you the highest-quality care in the nation. How?
It comes down to competition — competition to give you and other focused-network patients the best outcomes using the right treatments. Focused networks consist of hospitals along with associated physicians and facilities that are selected based on their procedure- and patient-outcome rates. They must be in the top 10 percent in their group to be part of the network. If a hospital, its physicians and/or its facilities are not performing within the top 10 percent of their respective groups nationally, the health insurance company will not pay them incentives.
Hospitals, physicians and facilities now have a vested interest in providing quality outcomes for you, the patient. Competition for a spot in the top 10 percent creates a patient-centric environment where care for the “whole you” is practiced.
That type of quality surely has to cost more, right?
Focused networks offer you a lower monthly premium because they are incentivized to get and keep patients healthier. Their savings are not sustainable if a patient gets sicker and needs progressively costlier care. A focused network is a solution that can save both worker and employers 15 to 20 percent.
One potential drawback is that your doctor might not be in the network. Some advice: double check. Your doctor could be listed under a physicians’ group name rather than under his or her individual name. If it’s definite that he or she is not in the network, you may be able to go out-of-network, but you will pay more out-of-pocket costs. Before you do that, ask yourself some questions:
- How often do I see this doctor or specialist?
- Do I see the doctor or do I see the nurse practitioner?
- How does my doctor rate when it comes to quality patient outcomes?
- How much could I save by changing doctors if I join this focused-network plan?
- Would it really be difficult for me to change doctors?
This is a personal “What does it mean to me?” decision that only you can make. You should look at your outcomes, your plan cost and your own out-of-pocket cost. You’re going to receive the best benefit by changing your provider and staying within the focused network.
Because of the benefits these focused networks can provide, Concordia Plan Services is working with our network and benefit administrators to bring them to areas as they become available in the market. We’ve already introduced these options in areas of Arizona, Florida, Illinois and Texas, and we anticipate the list to grow quickly. Stay connected with Concordia Plan Services to hear more as the future of health care unfolds.