Frequently Asked Questions

Why are healthcare costs rising?

Healthcare costs are on the rise due to a number of reasons, including hospital consolidation, costly technology, an outdated reimbursement system that rewards quantity of care rather than quality, overpriced prescription drugs, administrative inefficiencies and harmful lifestyle habits.

Why does hospital consolidation lead to higher costs for me and my family?

As hospitals acquire other hospitals, as well as specialty medical practices, that means less competition. In turn, this has given providers unprecedented pricing power and leverage to drive up costs, ultimately impacting you and your family. A recent study by the Robert Wood Johnson Foundation, for example, shows that cost of care at merging hospitals that are located near one other typically increases by 40 percent or more.

If a hospital acquires my doctor’s practice, will the cost I pay go up?

Our research shows that BCBSAZ members pay as much as 20 percent more for a doctor’s office visit at a hospital-owned practice than they do at an independent provider. That number increases to 30 percent for specialty doctors, such as orthopedists or cardiologists.[1]

[1] BCBSAZ Internal Claims Data 2015

 

My deductible and out-of-pocket expenses are capped, so why do I really need to worry about the increased costs?

What healthcare providers charge, directly impacts what you pay, especially if you have a plan that requires you to pay a percentage of the cost (coinsurance). What you pay goes up proportionally with the charges. And, over time, we all pay more. As provider costs go up, so do the cost of premiums. That’s why is so important for consumers, insurers and providers to work together to better manage costs.

Why are healthcare costs rising?

Healthcare costs are on the rise due to a number of reasons, including hospital consolidation, costly technology, an outdated reimbursement system that rewards quantity of care rather than quality, overpriced prescription drugs, administrative inefficiencies and harmful lifestyle habits.

What is BCBSAZ doing to control costs?

BCBSAZ will continue to push for Arizona’s healthcare providers to become more transparent and accountable to our members. We will seek out providers who will work collaboratively with our members to provide more and better information about treatment costs and options. Our members need this information to make smart decisions on how they spend their healthcare dollars.

We will also continue to demand a greater level of accountability from providers, so the focus is on better health rather than the number of services provided.

Our Patient Centered Medical Home (PCMH) program is a good example. The goal of the PCMH program is to improve patient care outcomes by encouraging primary care physicians to practice evidence-based medicine. Chronic conditions such as asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure and diabetes have a major impact on healthcare costs. We link arms with physicians to promote comprehensive, coordinated care for patients with these chronic conditions. Our model encourages physicians to work with their patients to set and achieve measurable performance metrics that will improve overall health and reduce costs.

What can I do to control costs?

BCBSAZ believes an informed healthcare consumer is a powerful tool in controlling rising costs. We’re asking our providers to better inform our members about costs and treatment options to ensure you have the information you need to make the best healthcare decisions possible.

Here are some things you can do to help control how much you spend on healthcare:

  1. See your primary care provider first, rather than a specialist.
  2. When prescribed medication, request generic drugs. These are just as effective and are often more affordable.
  3. Shop around. Compare the cost of procedures by contacting several providers to determine the best value.
  4. If it’s not a true emergency, consider an urgent care center and you could pay as little as one-tenth of the cost of the ER. Some urgent care centers are open 24-hours and on holidays, making them not only cost-effective, but also convenient.
  5. Request itemized hospital bills. As many as 80 percent of bills may have errors.[1]
  6. Take advantage of your preventive care benefits. These often cost nothing out-of-pocket.
  7. Eat healthy and stay active to help prevent chronic disease.

[1] ABC News, 2013. Accessed November 2015.

What should hospitals and other providers be doing to control costs?

BCBSAZ is working with healthcare providers to more effectively manage and coordinate care so our members get the right treatment at the right time, while eliminating inefficiencies, redundancy and waste that drive healthcare costs for our members. The following are a few ways healthcare providers can better control costs:

  • Reduce preventable medical errors such as in facility infections which alone costs up to $33 billion a year.[1]
  • Better analysis of patient data to learn best practices that help guide members along a more affordable path of treatment that delivers better care.
  • Stop unnecessary or duplicate testing which costs more than $200 billion a year.[2]

[1] CDC, 2012. Accessed November 2015.

[2] The Wall Street Journal, 2014. Accessed November 2015.

Where can members get support?

As a local company with 76 years of serving Arizonans, we know this may be a transition for you and your family. Our team of professionals will work diligently with you and your family to help you to continue to receive access to covered health services. If you have questions, please call the number on the back of your BCBSAZ insurance ID card.To stay up to date on industry trends that are affecting healthcare costs and what BCBSAZ is doing to minimize the impact on Arizonans, continue to visit In Your Corner for information.