Overcoming The Hospital-Location Barrier To Seeking Better Care

In real estate, the three things that matter most are: location, location, location. The same goes for healthcare for U.S. businesses and employers.

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. Employers must consider the costs that location impose upon their staff and their care.

You Can’t Impact The Past: ↑ Advocacy + ↑ Quality = ↓ Cost

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Thursday, May 20, 2021, 2:00 PM ET / 11 AM PT

Unlike most things, healthcare services have an inverse relationship between cost and quality: the better the quality, the lower the cost. Unfortunately, the current health benefits market is completely opaque and lacking any meaningful, realistic transparency. Additionally, we have always been taught that easy = better when designing health benefits programs for employers and their employees. However, the cost and quality of healthcare can vary dramatically within the same city. Utilization Management for example, where your members access healthcare, is one of the single most important additions to your health plan design.

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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 for your team.

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 and work, but you can avoid the most expensive facility near you. Steer clear of “down the hall;” let a healthcare advocate point your team’s needs to the best care at the lowest price.