The government provides pricing for drugs and procedures, but in many cases those listings only highlight what Medicare and Medicaid are willing to reimburse, not what those services actually cost, according to change:healthcare.

Hospitals, physicians, and insurance companies provide patients with an itemized bill for care after the fact. The Healthcare Transparency Index, issued by change:healthcare, Brentwood, Tenn, provides health care consumers with ongoing trends data about actual health care costs and opportunities for cost savings.

With more than 60% of employers in the United States expected to offer a consumer-directed health plan (CDHP) in 2011 as a way to curb costs, employees and their families will be increasingly accountable for shopping and paying for their health care–so understanding the costs involved is key.

The inaugural Healthcare Transparency Index, to be issued quarterly, includes data derived from more than 1.3 million medical claims, totaling $220 million, from 90,000 individuals across all 50 states over a 12-month period.

The company’s Web-based Cost Transparency Solution provides employees with personalized views of pricing information and proactive alerts that highlight opportunities to save money on routine care and prescriptions in their area.

Key findings include:

  • Prescription drugs offer the highest opportunity for cost savings ($8 million across the HCTI data set), followed by dental, routine primary care physician office visits, psychotherapy, physical therapy, and chiropractic.
  • Costs for commonly prescribed drugs can vary greatly. The following prescription drugs offer the greatest opportunities for cost savings for both brand names and generics–by simply switching pharmacies. In fact, an Abilify consumer could save up to nearly $2,500/year by making a pharmacy change.
  • Wal-Mart, Target, Kroger, CVS, and WalGreens top the list of pharmacy chains with the widest prescription cost discrepancies for both brand name and generic drugs.

While CDHPs have been hotly debated for the past several years, businesses continue to demonstrate financial benefit through the implementation of these plans, according to change:healthcare. More than 50% of US companies offer a CDHP, including Microsoft, Kraft, GE, and General Motors. According to the recently released Government Accountability Office study, CDHP enrollees spend $2,000 less than enrollees in traditional plans.

"As an economist, I believe a CDHP is the only version of health insurance that makes any economic sense, because in that model, the individual actually cares about the price of services when they’re making the decision about what to consume," said R. Lawrence Van Horn, associate professor of Healthcare Management and faculty director, Healthcare Programs, at Vanderbilt University’s Owen Graduate School of Management, in a statement. "The main challenge that employers have with moving to CDHP is educating employees and changing their mentality around the accountability–employees have to actually care about the health care costs they’re generating, and make sound and wise purchases."

[Source: change:healthcare]