Are Groupons For Healthcare Good or Bad? Yes

Groupons have been in the medical news lately (for example “Groupons For Medical Treatment? Welcome To Today’s U.S. Health Care” and “Groupons for medical care are helping patients save money“) with stories of deeply discounted rates for some medical tests in several local markets across the country.

Here’s the net of the good and bad from a smattering of the news reports.

Good because the lower rates may make the tests affordable for some who need them and who may otherwise pass because they simply can’t afford.  In other words, if you have to have a test and don’t have coverage or if you have coverage but your plan’s deductible coupled with your network’s contracted rate for the test are out of reach, the Groupon rate may make it affordable.

Bad because the discounted rates sometimes prompt people to undergo testing unnecessarily and often without their doctor’s input or supervision.  In some respects, it could be a cousin to a practice known as “predatory testing” (offering free initial tests designed to encourage more not so free tests and/or costly treatments…….when they may not be necessary or advisable in the first place.)

And, bad because the quality is sometimes not up to par leading to a retest which usually ends up being performed somewhere else at an additional cost.  Essentially, patients end up having to pay multiple times to have the test done right.

According to one of the reports “Groupon dictates the price for its deals based on the competition in the area — and then takes a substantial cut”…

‘They take about half. It’s kind of brutal. It’s a tough place to market,’ said a provider that signed on with Groupon to market for his testing facility.”

Makes me think we could do just as well or even better fending for ourselves with a qualified provider of our choosing without Groupon as the middleman.  If a test is needed, first talk to your doc and ask for a list of multiple qualified providers.  And/or, check your insurance carrier’s online provider network directory for participating providers. Most insurance carriers now have online cost comparison tools that you can access by logging into your account. They are simple to use and allow you to shop for where you receive your healthcare. Once you have your lists of providers, check for quality ratings and pricing information.

After you do a little homework, select a few qualified providers.  Ask each of the providers for their best rates; and, what kind of break they’ll give you for pre-payment or paying in cash.

bbg65Plus Certified To Facilitate National Medicare Educational Program

Medicare can be daunting and confusing and quite difficult to grasp.

This is true in the case of existing Medicare beneficiaries as well as their care givers.  And, it’s especially true for those prospective new enrollees who are about to turn 65 and have to deal with trying to understand their Medicare options for the very first time. 

The Medicare Minute was created and sponsored by the Medicare Rights Center to help address and alleviate some of the confusion surrounding Medicare. The program consists of an ongoing series of free monthly educational programs designed to equip people with the knowledge to more clearly understand their Medicare options, to make more informed decisions, and to ultimately utilize their Medicare coverage more effectively. 

Volunteers from across the country with experience in how health benefits work serve as facilitators for the Medicare Minute educational programs.  And, bbg65Plus is now certified and appointed to serve as a Facilitator of the Medicare Minute program. 

The Medicare Minute educational program is available free of charge to employers, organizations, and community groups interested in educating members on the ABC’s (and Part D) of Medicare. And now readers of our blog will be able to read a summary of some of highlights and key tips from those programs in this space each month. 

To learn more about the Medicare Minute educational programs and how you can schedule Medicare Minute presentations for your organization, contact Tom Barrett, Medicare Minute Facilitator for bbg65Plus at 866.845.8600 x130 or tbarrett@bbginc.net.

For more information — go here  1 Medicare Minute Overview and here 2 Medicare Minute FAQ

When It Comes To Lowering Healthcare Costs Do Workplace Wellness Programs Over-Promise And Under-Deliver?

Don’t get me wrong, I completely support the notion of promoting positive health behaviors and healthier lifestyles. Encouraging such things as regular exercise, good and balanced nutrition, the proper amounts of sleep, and all the things associated with taking better care of ourselves is all good. No question about that.

It’s just that for the most part you could color me the doubting Thomas when it came to believing the narrative that wellness programs definitively lead to lower insurance premiums and other healthcare-related cost savings.

And, it seems that most often that’s how wellness programs have been sold to employers. “Implement a wellness program and you will lower your company’s insurance premiums and other employee health-related costs” has commonly comprised a major part of the wellness sales pitch made to employers.

And many employers, especially large employers, have been buying this cost savings aspect of it. (80% of large employers in the U.S. offer wellness programs*).

I’ve long wondered if these corporate wellness programs provided any direct return on an employer’s investment (Workplace wellness is an $8 billion industry*). We sure haven’t witnessed it either in the way of lower insurance premiums or a decrease in the consumption of medical services and medical claims.

Harvard provides an answer via a major study on the Health and Economic Outcomes of Workplace Wellness Programs.

Results of the Harvard study were recently published in The Journal of the American Medical Association (JAMA). In a nutshell the Harvard study concluded that while there were significantly greater rates of some positive health behaviors among participating employees, there were no significant effects on health care spending.

In other words, when it comes to wellness programs and savings, the Harvard study verdict is in. Under-deliver.

For more on the Harvard study click here.

*Source: Axios

Déjà Vu, Again – Small Group Transitional Relief Plans (pre-ACA) Extended Through 2020

Buried far below the most recent headlines related to eliminating the ACA, The Centers for Medicare and Medicaid (CMS) once again announced that employers in the small group market still enrolled in Transitional Relief Plans (pre-ACA) may keep their existing policies and plans for another year. CMS stipulates that ultimately the discretion for granting an extension again rests with state regulators and the respective participating insurance carriers who continue to make those plans available.  As we learned last year a few insurance carriers (e.g. Aetna) elected not to extend the Transitional Relief Plans beyond 2018. They instead chose to eliminate the option of renewing the old plans thus requiring impacted employers to move to ACA plans or one of the market compliant alternatives (e.g. level funding, MEWA, etc).

For more info click on the link below:

Extended Non-Enforcement of Affordable Care Act-Compliance With Respect to Certain Policies