Incentive and Redirection Program Saved 7 Health Plans Nearly $11 Million in 2014
May 6, 2015 – LYNDHURST, NJ – Can people get paid to go to the doctor? Vitals is doing just that – and generating significant savings for consumers and health plans in the process.
Vitals’ SmartShopper transparency and rewards program paid consumers a total of $1.3 million in cash and saved health plan clients nearly $11 million dollars by redirecting members to lower-priced, similar quality care facilities. The figures are part of SmartShopper’s Book of Business report which chronicles savings consumers generated by comparison shopping for medical care. The report details the savings across seven health plans in 2014.
The report reveals that consumers saved $780 on average for an MRI when they booked their scan with SmartShopper. The implication is that there is $23 billion alone in potential savings on just the 30 million MRIs performed in the country each year.
Potential Savings by Procedure
|Procedure||Savings from SmartShopper||No. of Procedures Performed (annually)||Potential Savings Amount|
|CT Scan||$502||80 million||$40.2 billion|
|MRI||$780||30 million||$23.3 billion|
|Colonoscopy||$1,351||14.2 million||$19.2 billion|
|Mammogram||$64||16 million||$1 billion|
“When you extrapolate these numbers across the broad range of medical procedures performed each year, creating a marketplace where consumers can shop for care as they do for other purchase decisions has tremendous potential to impact medical costs,” says Rob Graybill, VP of Vitals SmartShopper. “As shopping for medical care becomes more commonplace, market forces will truly bend the medical cost curve.”
SmartShopper empowers members to direct their care towards better value providers. It works like this: When a procedure is ordered for a patient, the member logs into the SmartShopper website or calls the help center to understand costs and quality ratings for various facilities in their area. If they choose a lower-priced provider, the member is rewarded with an incentive check. These dollars are provided by the health plan or employer, who sends a portion of the savings back to the patient after the final claim is received for verification.
A challenge for health plans has been getting consumers to care about price when selecting medical care. In addition, consumers can be reluctant to shop for alternatives when their doctor has given them a recommendation for a specific facility. The Vitals SmartShopper cash reward program essentially pays consumers to shop around.
High-volume services like colonoscopies ($2.4 million), MRIs ($1.9 million) and blood tests ($831,135) made up a significant portion of the savings. Yet, specialty drugs, like Remicaid ($821,287), yielded impressive savings with less patients. That’s because outpatient hospital centers typically charge more than infusion centers, where SmartShopper redirects. The result: almost $8,000 in savings per infusion.
Top Procedures by Total Savings
|Service||Total Clients||Total Savings|
“We haven’t yet arrived at a place where consumers can easily find pricing – and the reality is that many care facilities inflate price,” said Graybill. “Our goal is to reduce overspending and shed light on cost and quality options available to consumers.”
To access more information about savings or incentives by procedure, download the report.
Vitals is reinventing the way people shop and save on their medical care. We support effective decision-making through cost, quality and access data, as well as reward and incentive programs. Vitals leads the market with the first transparency and engagement platform that achieves measurable savings for consumers through a retail-like approach to purchasing health care services. Through health plans, hospitals and our leading consumer websites, Vitals helps more than 150 million people each year access better, more affordable care.