Wednesday, November 16, 2011

Survey: Medical Costs Will Rise in 2012 — Here's How to Save

Medical costs keep increasing, even in a bad economy. A recent survey by the National Business Group on Health found that 53 percent of employers plan to raise their employees' share of premiums in 2012.

Even if you're lucky enough to have insurance, out-of-pocket expenses are also rising, says Dr. Howard Brody, director of the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston.

"The amount that insured patients have to pay has been steadily increasing over the last several years," he says. "Even with insurance, economics can still come down on you hard in the form of co-pays — the portion of the bill you end up paying."

Fortunately, there are steps you can take to cut the total costs of office visits. They include:

• Have an established physician. "The patients I could help to stretch their dollars the most were those who were established in our practice," Brody says. "I had seen them before, I knew their health history, and my office staff knew them. When they called on the phone asking if they should come in or not, the nurse could give really good advice over the phone."

• See doctors in the same network. "Getting established with a group of doctors in a clinic or group practice is a huge way to save money," Brody says. Doctors in the same network, even though they have different specialties, have your medical records and can streamline your care. "If the doctor doesn't know you or have records on you, that's when the bill gets sky-high. Tests and X-rays will be ordered that are unnecessary in retrospect, but the doctor has to be thorough."

• Go to your family doctor before seeking a specialist. Your problem, such as back pain, can often be solved at a lower cost. "Primary care physicians can handle between 90 and 95 percent of people who walk in the door and should be the first doctor you see," says Brody. "If you do need a specialist, your primary doctor can help you choose the best one. People who try to shortcut by going to a specialist first often end up with lesser quality medical care, and they certainly have higher-cost care."

If you need to see a number of specialists, your primary doctor can coordinate your care. In addition, he or she may be able to see relationships between symptoms that can be treated by one specialist instead of two or three.

• Tell your doctor your financial situation. "Don't be embarrassed if you're having financial difficulties," Brody says. "I appreciated patients who were upfront with me and said they had limited resources. Just having a reminder from the patient to keep that in mind helped me to be sure that everything I recommended was absolutely necessary."

• Discuss lifestyle changes. "Lifestyle changes are difficult, and an alliance with your healthcare specialist can help you reach your goals," Brody says. Some health problems, like high blood pressure, can often be addressed by changes in lifestyle. "Ask your doctor if your health goals can be accomplished by a lifestyle change rather than taking a medication."

• Make good use of time. Most offices charge depending on the length of a visit, so prepare a list of questions in advance to ask. If your list is long, check with office personnel to make sure enough time has been scheduled for your appointment.

• Consider office workers your allies. Office workers can give estimates of costs before you see the doctor. Let them know if you don't have insurance, and you may get a price break. Also ask if there's a discount for paying cash — even a small percentage helps. "Be frank about your needs and wants," Brody says.

• Don't automatically head for the emergency room. According to the New York Times, the top three reasons for visiting emergency rooms are non-emergency — sprains and strains, superficial injuries and contusions, and upper respiratory infections. The typical cost for visiting an emergency room, according to the Medical Expenditure Panel Survey, was $569, but the average cost was $1,265. Instead, go to the nearest urgent care center where you'll be charged a fraction of an ER bill and will probably get faster treatment.

• Need a flu shot? Instead of making a trip to your doctor's office, check out local community-supported health centers and local pharmacies. Both may offer annual flu shots at low rates.

• Get the most from your deductible. If you have met your deductible for the year, consider having necessary non-emergency procedures done before the end of the year.

• Go digital. More doctors are offering advice by email at lower costs than a traditional office visit. Digital visits are generally most useful for simple conditions, such as sinus and urinary tract infections. Some insurance companies, including Aetna and Cigna, cover digital visits. "I think being more accessible to patients could really help with lifestyle changes and prevention," Brody said.

• Use the phone. Some health plans and medical practices offer a service where patients can call for advice on whether or not they need to see the doctor. And if you're an established patient, you can often call and get advice from the nurse at no charge.

• Don't postpone needed medical care. "Don't be penny-wise and pound-foolish," Brody says. Some medical problems that could have been easily treated can become a life-threatening emergency. Then you may need the services of a wallet-busting emergency room. State or local health departments, which usually charge on a sliding scale depending on your income, may be viable options if you're sick and your wallet is anemic.

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