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Why You Shouldn’t Make Choices on Healthcare Costs Alone

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As healthcare costs and the average deductible and copay continue to rise, you may be looking for ways to lower the amount you’re paying for the care you receive. A recent report from the Health Care Cost Institute (HCCI) found that the cost of common services, from surgery to diagnostic tests and X-rays, can vary tremendously, even within the same state. That might suggest that you should shop for healthcare based on price. While price is one important factor to consider, choosing where to receive medical care is not a decision that you should base solely on cost.

Why do healthcare costs vary?:

The HCCI report found that in some states, more than 20% of healthcare costs are twice the national average while in others more than 90% of the cost of these services are priced lower than the national average. Interestingly, there were even significant variations in price within states. In California, for example, knee replacement in one area of the state was almost $30,000 less than in another.

One probable cause for these variations in healthcare costs is the consolidation of hospitals. In some areas of the country, smaller hospitals have been brought together as part of a larger health system or have left the market. This reduces competition, which in turn may lead to higher prices for medical services.

Factors you should consider when choosing care:

When deciding where to receive care, consider not only the cost, but also the quality of care. There are a number of sources of information that provide information on surgical complications, deaths, rates of readmission to the hospital, as well as the results of patient satisfaction surveys. While this information is valuable, it may not tell the whole story. Hospitals that take care of more complex patients may have greater experience and better outcomes than is represented by data that is not risk adjusted. Also, many hospitals choose not to provide data to all sources and thus the results give an incomplete picture of true quality.

The experience and expertise of your physician is another important factor to consider. You should ask your physician about:

  • His or her credentials, including board certification and fellowship training
  • How often he or she performs the procedure you need
  • What his or her complication rate is and other outcome information, such as recovery time and potential complications

In some cases, you may want to consider seeking care at a medical center of excellence with more specialized experience rather than a community hospital that’s close to home, especially if you’ve been diagnosed with a serious or rare condition that most physicians and hospitals don’t treat frequently. At a center of excellence or academic medical center, you may be able to find a physician who specializes in treating your condition or is active in researching new treatments, which can give you access to more effective approaches and/or clinical trials.

While quality of care is extremely important, you should also feel comfortable with and confident in your physician:

  • Does your physician explain your condition and treatment options in language you can understand?
  • Are you able to ask questions and raise concerns?
  • Is your physician open to discussing alternative options to the treatment that he or she has recommended and willing to explain the risks and benefits of each treatment?

Comparing healthcare costs can be valuable, since it doesn’t make sense to pay more for the same quality of care. But for the best outcomes, it’s important to make an informed decision about your care that takes into consideration quality and a patient-focused approach to care as well as cost.

Talk to your SunTrust Private Wealth Management advisor about connecting you with PinnacleCare to learn how they can help you choose the right healthcare for you and your family. Learn more about SunTrust Private Wealth Management.

Disclaimers

This post originally appeared on PinnacleCare.com. PinnacleCare is an unaffiliated third party private health advisory firm that provides support for a broad range of healthcare needs and assistance with health risk management and planning.

This content is educational in nature and should not be considered a solicitation for business. It does not constitute any specific medical, legal, tax, accounting, financial or investment advice. You are encouraged to consult with your physician and competent legal, tax, accounting, financial or investment professionals based on your specific circumstances. We do not make any warranties as to accuracy, timeliness, or completeness of this information, do not endorse any third-party companies, products, or services described here, and take no liability for your use of this information.

This content does not constitute legal, tax, accounting, financial or investment advice. You are encouraged to consult with competent legal, tax, accounting, financial or investment professionals based on your specific circumstances. We do not make any warranties as to accuracy or completeness of this information, do not endorse any third-party companies, products, or services described here, and take no liability for your use of this information.