OMAHA, NE – Alegent Health, a nine-hospital system in and around Omaha, Neb., is one of the first in the nation to provide consumers with accurate estimates of the cost of their care, factoring in insurers’ payments and discounts.
The not-for-profit system is providing the estimates on its Web site as part of ongoing efforts to foster consumerism and increase price transparency for those in its service area. System executives say they are taking steps to patent the cost-estimating technology and other components of the service.
Through Alegent’s “My Cost” service, the system can provide visitors with secure access to a calculator that can provide out-of-pocket cost information that takes into account a visitor’s insurance coverage.
Alegent said it can provide out-of-pocket cost estimates for nearly 500 common treatments and procedures. The estimates take into account the negotiated discounts that Alegent Health has in place with payers.
The service went live late last month, and Alegent was able to immediately provide detailed cost information for an estimated 50 percent of its customers.
Those covered by United Healthcare can see their estimated bill with all discounts automatically factored in, while those covered by Medicare Parts A and B, Coventry Healthcare of Nebraska, Aetna or CIGNA are redirected to those Web sites before they get their out-of-pocket estimates, said Scott Wooten, the system’s CFO.
In the next few months, Blue Cross Blue Shield of Nebraska customers are expected to be able to use the tool. Alegent will continue to work with Mutual of Omaha and other health insurers so their members can use the estimator, Wooten said.
My Cost uses the HDX application from Siemens Medical Systems to enable quick access to insurance information, he said.
In the first week, some 8,000 to 10,000 individuals went through the portal, said Troy Harrison, vice president and director of technology development at Medseek, a Solvang, Calif.-based vendor that participated in development with Alegent.
The health system can produce near real-time estimates for costs because it has working relationships with insurers, enabling access to data feeds that permit accurate results for estimating contractual discounts and patient co-payments, Harrison said.
In addition, self-pay information will be available for other site visitors, as well as guidance to estimate the amount of financial assistance for which patients might qualify.
“With My Cost estimator and our quality reporting, we are providing a transparent system that helps consumers understand their true healthcare costs and expected outcomes for various treatments and procedures,” said Wayne A. Sensor, Alegent’s CEO.
In the next six to 12 months, Alegent Health hopes to add professional fees, such as anesthesiology, radiology and physician fees, to its cost estimates. Currently, the estimator provides only facility fee estimates.
Alegent will try to gain cooperation from independent physician practices, Wooten said, and find a way to provide a better link between quality metrics and cost metrics, he said.