Medical Marketing Trend: Health Care Insurers Go Generic

Medical Marketing Trends for 2012

When you go grocery shopping, do you buy name brand or generic? What about when you shop for shoes and clothing – are you willing to pay a little more for brand names? As a physician, do you prescribe brand name drugs for your patients or save them money with less expensive generic counterparts? Of course, the benefit of buying generic is the reduction in price.

Well, a new medical marketing trend suggests health-care insurers are out to save money by utilizing new cost-savings programs such as Anthem’s Compass SmartShopper and Harvard Pilgrim Health Care’s SaveOn. Not exactly generic, these programs are, however, aimed at finding less-expensive health care providers.

The story from Kaiser Health News explains how health-care-insurance carriers are making efforts to reduce costs by asking members to seek out the lowest cost provider. The benefit to members is lower copayments and cash back.

Here’s how the process typically works:

• Members who have been referred for treatment review a list of low-cost providers
• If the referred provider is not on the low-cost list, the member may request the doctor change the referral to a provider on the list
• After the provider submits the claim for payment, the insurer reviews online and telephone inquiries to determine if the member chose to use a low-cost provider
• Members who use a low-cost provider on the list will receive a check in the mail within 60 days

According to the KHN article, some Anthem Blue Cross and Blue Shield members in New Hampshire, Connecticut, and Indiana may be eligible to receive up to $200 for choosing a less expensive facility for diagnostic tests or elective procedures, such as mammograms and MRIs.

Because the cost of using facilities can vary greatly, choosing to use a less expensive facility can often reduce the cost of a procedure by as much as 50 percent.

Naturally, some physician groups are concerned about giving economic incentives without considering quality. “It’s a fair criticism, insurers concede. Listed providers are licensed and credentialed, but quality indicators such as complication rates aren’t factored in.”

While some feel that choosing a provider based on cost for simple diagnostic tests or radiology procedures is probably fine, surgery is another matter entirely because quality varies so greatly. Additionally, physicians indicate they are concerned that these cost-savings programs may actually hinder coordination of care among providers.

Naturally, coordination of care is vital to managing a patient’s health and controlling costs. That’s why ReferralMD is such a great resource. It streamlines the patient-referral process so you can access, manage, and share digital referrals and improve the patient experience.

Take a tour now and find out how simple it is.

And while you’re at it, give us your thoughts on cost-savings programs like Anthem’s Compass SmartShopper. Are they a good medical marketing idea by insurance carriers?