Thursday, October 27, 2011

Blue Light Special for Wellpoint

The SmartShopper program by the insurer WellPoint is expanding and there is something very interesting about it.  The program rewards patients by giving them a cash refund when they get tests and procedures that are "cheaper".  Of course, they don't use that word.  They use the term "cost-effective settings" but the rebates are real.  Here is how it works.  The physician "recommends a test or procedure, a member calls a toll-free number or goes online to compare prices at nearby facilities. The rebates are available for tests such as MRIs and CT scans, and procedures such as bunion removal and spinal fusion".  The negative side is that it may push patients to facilities or doctors who are churning through patients to make up the difference in volume or to facilities or doctors who just suck.  If that can be accounted for, however, then there is a positive side.  Having patients understand the pricing of their medical care is a good thing and can lead to lower costs.   That is, however, if the insurers decide to decrease their premiums.