For profit health care and for profit health care financing creates some unusual anti competitive behaviors.  The new York Times “upshot” (6-30-20) details tope friends receiving the same COVID test.  One pays $199 in cash.  The other has their insurance plan billed $6,408.  See the story here:

What is going on?  We see this all the time.  A MRI at a CT hospital may cost $3,000 while an outpatient facility may charge $700 for the same test.  We don’t need to blame the hospital who has to keep the MRI staffed 24/7, but we don’t need to pay the higher cost, either.  For many of our plans, the most common payment amount for a COVID test is $59.  But we have seen tests performed at non network labs costing the health plan over $250.

At Stirling Benefits, we custom design health plans that reward members when they choose high value, lower cost care.  When members help the plan save money, the plan lowers what the member pays out-of-pocket.

Are you interested in bending the curve on health care costs? Would you like a second opinion on your options? We may be able to save your firm tens or hundreds of thousands of dollars and offer a plan you can be proud of!

Click for a free consultation.