Health Care Service Corporation's Transparency Solution Helps Consumers Better Manage Health Care Services And Costs

Provider Finder Cost Estimator Assists Consumers in Making More Informed Health Care Decisions

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Sep 10, 2014, 09:00 ET

CHICAGO, Sept. 10, 2014 /PRNewswire/ -- As consumers look for new ways to obtain the best possible care and lower health care costs, Health Care Service Corporation (HCSC), the nation's largest customer-owned health insurer, announces the enhanced Provider Finder, an online health care solution developed to enable members to more easily research and select physicians and hospitals, as well as estimate out-of-pocket health care costs. The Provider Finder provides cost estimates for more than 400 common medical procedures, increasing to 1600 by the end of the year.

Provider Finder allows members to search and compare more than 400,000 health professionals and 21,000 facilities nationwide, estimate treatment costs, access clinical quality data and read and write patient reviews. HCSC analyzed the use of Provider Finder for approximately 800,000 members and found that members who acted on a Provider Finder recommendation saved on average $900 per procedure.¹

"Our Provider Finder solution provides member's access to the information they most often want when they are searching for a physician and need to know how much their care will cost," said Tom Meier, vice president, product development, HCSC. "Our commitment to improving healthcare transparency is part of our holistic approach to provide our members with the critical information and tools to help them make the best health care decisions for themselves and their families."

Recent research indicates that consumers may pay as much as 683% more for the same medical procedures, in the same town, depending on the facility they choose.² For example, the total cost for a knee replacement in the Dallas area could range from $18,801 to $47,324 depending on the facility.³ The Provider Finder offers members a simple, easy to navigate website, to help in selecting the best provider for their needs, based on location, clinical quality and costs. A few unique features include:

Out-of-pocket costs. Unlike other transparency solutions that rely on estimated costs, the Provider Finder uses an expansive, proprietary database to provide information on out-of-pocket expenses. Member out-of-pocket estimates are based on a member's own health plan benefits including health reimbursement and health savings account balances.
Unparalleled provider demographic data. The Provider Finder includes a large library of patient reviews of physicians and facilities, as well as photos and information on average wait times and physician training, expertise and awards.
Extensive Provider Clinical Quality Data. Members can evaluate the quality of care with data from Blue Distinction/Blue Distinction+ Centers, Bridges to Excellence, National Committee for Quality Assurance (NCQA) distinctions and Physician Quality Measurement data.
Online Appointment Scheduling.⁴ Members can view available times and schedule appointments online, streamlining access to cost effective care.
Educational Videos.⁵ Members have access to hundreds of educational videos that provide an interactive overview of common health conditions and recommended lifestyle changes that may help members manage their conditions.

"Our goal is to optimize the value of health care for our members and the entire health system by advocating for quality care at lower costs," said Dr. Stephen Ondra, Chief Medical Officer, HCSC. "By providing information on clinical quality, patient outcomes and satisfaction, we empower our members to make better informed health care decisions which we believe can help drive higher quality experiences and lower out of pocket costs for the consumer."

The Provider Finder is part of a suite of custom solutions developed by HCSC to engage and empower members to make smart health care decisions. Provider Finder is available to group members of Blue Cross and Blue Shield of Illinois, Montana⁶, New Mexico, Oklahoma and Texas via Blue Access For Members and will expand to allow access to all group PPO and HMO members in those states by the end of 2014.

In addition to the Provider Finder, our transparency suite includes Benefit Value Advisors (BVA), specially trained customer service advocates who use Provider Finder and other tools to provide consumers various health care choices; Reference Based Pricing, a solution which uses plan design elements to motivate members to understand the cost of certain procedures; and other proprietary tools to provide consumers with choices that allow them to maximize their health care benefits.

About Health Care Service Corporation
Health Care Service Corporation (HCSC) is the country's largest customer-owned health insurer and fourth largest health insurer overall, with more than 14 million members in its Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas. A Mutual Legal Reserve Company, HCSC is an independent licensee of the Blue Cross and Blue Shield
Association. HCSC has a rating of AA- (Very Strong) from Standard and Poor's, A1 (Good) from Moody's and A+ (Superior) from A.M. Best Company. For more information, please visit www.HCSC.com, visit our Facebook page or follow us at
www.twitter.com/HCSC.

¹ Savings Opportunities are based on health claims measured in allowed dollars incurred 3/1/2012 – 2/28/2013 and paid through 5/31/2013 for PPO group members.
² Change: healthcare 2011 Transparency Index Study
³ Note that dollars stated are allowed dollars, not patient share. The providers searched were within a 10 mile radius of zip code 75201.
⁴ In select geographies
⁵ Available 1/1/2015
⁶ Montana treatment will be available 1/1/2015.