Monday, August 19, 2019

Consumerism Can Keep Prevention Costs in Check

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The old saying by Benjamin Franklin -- "an ounce of prevention is worth a pound of cure" -- has been taken to heart by many employers that want to better control the cost of their health care benefits.

Now, new research suggests that companies that promote a culture of prevention may want to preach an additional adage to their employees: When seeking a health care screening, look before you leap.

Numerous past studies and experts have pointed to the power of prevention in reducing health care costs by treating ailments before they bloom into significant conditions.  In recent testimony before a California state legislative committee, Alan Katz, executive vice president of SeeChange Health, noted that preventive screenings offer the best long-term strategy for reducing health care costs.

"Early-stage treatment of breast cancer costs, on average, nearly $14,000 per year, while late-stage treatment averages $61,000," Katz told the committee, according to a report by the Society for Human Resource Management. Savings clearly can be realized from prevention, even if it means "increased utilization [of health care services] in the short term," he said.

Not all preventive costs are equal, however. New research by Change Healthcare found that costs for some preventive exams can vary by as much as 700 percent, depending on where the patient seeks care. For instance, in an analysis of 15,000 consumers, the cost for a colonoscopy ranged from $786 to $1,819, according to a report on the study in USA TODAY.

The study cited a number of factors that can determine price, including whether a patient receives care in an urban or rural area; whether the patient visits a hospital, physician's office or clinic; and whether the provider specializes in a particular test.

Companies can shield themselves from some of the high costs by educating their employees about this variance and actively helping them find the best options for the price, Change Healthcare President Doug Ghertner told USA TODAY.

Another key question that employees need to ask when seeking preventive care is: Is this test really necessary?

A number of procedures, such as some imaging scans, have long been criticized as overused and ineffective. Recently, a foundation affiliated with the American Board of Internal Medicine released a list created by doctor specialty groups that names 45 medical services as typically unnecessary, according to a report in The Wall Street Journal. For instance, the American College of Radiology said patients with uncomplicated headaches usually shouldn't undergo an image scan. The same goes for those with general lower-back pain, the American College of Physicians recommended.

"We're not saying they should never be done," Dr. Christine Cassel, the foundation's CEO, told the WSJ. "We're saying these [screenings] are often unnecessary, and therefore the patients should ask the doctor, 'Gee, do I need this?'"

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