Health Care Consumers Realize Significant Cost Savings Through Benefits Value Advisor Program

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Apr 18, 2013, 07:00 ET

CHICAGO, April 18, 2013 /PRNewswire/ -- Consumers who worked with a specially trained customer service champion to help them navigate the health care system were found to make more informed decisions that resulted in significant cost savings, according to data analyzed by Health Care Service Corporation (HCSC), the nation's largest customer-owned health insurer.

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HCSC, which operates Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas, developed the Benefits Value Advisor program to help its members improve their quality of care and achieve cost savings in the overall health care system. A Benefits Value Advisor is a health care expert who uses data, cost estimators, provider-finders and other tools to provide consumers with choices that allow them to maximize their health care benefits.

From April 9, 2012 through December 31, 2012, HCSC analyzed the use of BVA for approximately 2,000 members from Blue Cross and Blue Shield of Illinois and Texas. Key findings include:

More than 90 percent of members who contacted a Benefits Value Advisor found they were eligible for savings through other health care options by pursuing care with an alternative provider.
Members who acted on opting for an alternative saw an average savings of approximately $2,000 per claim.
More than 50 percent of those members who were eligible for cost savings through this pilot inquired about MRI's, Colonoscopies and Childbirth.

Recent research indicates that consumers may pay as much as 683% more for the same medical procedures, such as MRI's, CT scans and other medical procedures, in the same town, depending on the facility they choose.[i] The following example further illustrates the potential variation in cost from one facility to another.

Customer A was in need of a colonoscopy with biopsy and found that in his home town of Duncanville, Texas, there were 46 facilities that offered his procedure. He decided to go to a facility recommended by a friend, and paid $2,438 for his services.[ii]

Customer B was in need of the very same procedure in the same town and rather than call a friend, he consulted with a BVA who used custom tools and found that the price for that procedure could range from $1,055 to $4,389. After speaking with a BVA, he decided to visit a facility near his home, which was significantly less expensive than the one Customer A chose, spending only $1560 on his procedure.[iii]

"HCSC is dedicated to finding ways to better deliver access to quality, affordable care in our communities," said Thomas Meier, vice president, product development. "Through this pilot program we found that members who utilized the company's Benefits Value Advisor achieved significant cost savings – and higher quality of care - through more informed decision making."

Benefits Value Advisor's use the following tools to help demystify healthcare for consumers:

Cost Estimator - compares cost estimates from myriad in-network providers and facilities;
Integrated Provider Finder - searches, compares and provides quality, patient reviews and cost information for in-network providers;
Emmi® Health Online Tutorials - provides interactive videos that detail specific conditions and procedures to help members understand the health care process better;
Pre-certification Coordination and Appointment Setting – provides an additional level of convenience to the member by scheduling appointments directly with the identified provider;
Live Transfers to Clinicians – identifies members who qualify for one of HCSC's wellness programs and connects them to clinical experts to address specific healthcare needs

"As the healthcare system continues to go through significant changes, we believe it's important for consumers to have a high-touch, personalized option to help them better understand their health care decisions," said Dr. Stephen Ondra, chief medical officer, Health Care Service Corporation. "Today's technology, coupled with personal interaction, provides an effective combination that engages members and helps them to make better health care decisions for themselves and their families."

About Health Care Service Corporation
Health Care Service Corporation is the country's largest customer-owned health insurer and fourth largest health insurer overall, with more than 13 million members in its Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas. A Mutual Legal Reserve Company, HCSC is an independent licensee of the Blue Cross and Blue Shield Association. For more information, please visit www.HCSC.com, visit our Facebook page or follow us at www.twitter.com/HCSC.

[i]Change:healthcare 2011 Transparency Index Study
[ii]Note that dollars stated are allowed dollars, not patient share. The providers searched were within a 25 mile radius of zip code 75116.
[iii]Note that dollars stated are allowed dollars, not patient share. The providers searched were within a 25 mile radius of zip code 75116.

SOURCE Health Care Service Corporation