Breaking Free From Hospitals’ Location-Network Chokehold

In real estate, the three things that matter most are: location, location, location. The same goes for healthcare.

We don’t often think about it, but where we receive our care makes a huge difference in the level of care we receive and the price we pay. For example, depending on your insurer, the cost for a knee or hip replacement at Sutter Health’s California Pacific Medical Center can be as much as $102,000. If you receive the same procedure done at Northwestern Memorial Hospital in Chicago, you could pay as little as $5,000.

Alternative Reimbursement: You Can’t Pay Less For Healthcare Unless You Pay Less For Healthcare

Thursday, June 10, 2021, 2:00 PM ET / 11:00 AM ET

The only way to pay LESS for healthcare is to pay LESS for healthcare. This simple statement sounds obvious but is ignored by most employers as reflected in their health benefits. For years, we have depended on the carriers to negotiate the price we pay for healthcare, having a more direct and transparent reimbursement (provider compensation model) is the key to immediately lowering your health benefits cost.

In a post-COVID world, even zero change in employees’ healthcare costs will likely still result in them spending a greater percentage of their income on healthcare. Why? Most household incomes are down so the focus shouldn’t be on maintaining the status quo, but on fighting to reduce overall costs and expenditures.

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Location makes a huge difference in the price we pay for healthcare, so where is the most expensive place to receive care in the United States? 

“Down the hall.”

When you need specialized care, whether it be an MRI, orthopedics, or anything else outside of your physician’s scope, most of the time you’ll be directed “down the hall.” However, “down the hall” is still part of a complex hospital system whose goal is to profit. In fact, on average, hospital systems employ 16 administrators per doctor, and the cost of those extra hands gets passed on to you. With nearly 70% of doctors employed or subsidized by hospital systems, there simply isn’t incentive to send you outside of their system. 

So while an independent clinic or specialist might be a better option for you, you may have trouble finding them, unless you have a healthcare advocate.  

A healthcare advocate knows your needs and also knows the entire breadth of care options available to you. Unlike a doctor who is incentivized to keep you within a hospital system, a healthcare advocate’s goal is to find you the highest quality care at the best price. As advocates are not supplemented by any hospital or insurance provider, they are truly independent and have only your best interest in mind.

A lot depends on location when it comes to healthcare. You probably can’t change where you live, but you can avoid the most expensive facility near you. Steer clear of “down the hall;” let a healthcare advocate point you to the best care at the lowest price.