Minnetonka, MN, June 19, 2006 - Answering the call to make available to healthcare consumers more information about cost and quality, Medica has launched an online resource that gives consumers actual cost and other information for a variety of outpatient and inpatient procedures at metro area facilities. The cost information is based on the health plan’s in-network contract rates with metro area providers in its Medica Choice® network.
Medica is providing access to this information as consumers are paying a greater share of their health care. The trend toward better informed, empowered consumers helps promote market-based reforms and greater competition.
“Transparency with our cost information is an important piece of moving toward a market where consumers can make decisions based on quality, price and therefore value,” said Dr. Charles Fazio, Medica’s chief medical officer. “They deserve to know what they are paying for and what options are available to them. It also creates a different accountability for providers, whose pricing has been difficult for our members to understand.”
The resource can be used to identify potential providers for a needed service and to plan financially for it. For example, a person who needs arthroscopic shoulder surgery can compare the actual cost ranges for the procedure at a number of outpatient facilities and obtain additional information on arthroscopy. For a more complex procedure requiring an inpatient stay, such as coronary bypass surgery, a patient can compare actual cost ranges at selected hospitals and review quality information about that procedure at each facility, including number of patients treated per year, average length of stay and complication rates. Expectant mothers can also compare the cost of delivering a baby at select area hospitals.
Providers are supportive of the transparency initiative because it provides them and consumers with information helpful to the patient-physician dialogue. “Medica is doing the right thing by making this information available to patients,” said Dr. Barry Bershow, medical director – quality and infomratics, Fairview Health Services. “As consumers are being asked to assume more of their health care costs, the information will be valuable to support patients and doctors in making thoughtful and appropriate health care decisions. Cost considerations increasingly are becoming an important part of that dialogue and it is helpful for physicians to be able to understand the cost implications of the way we practice medicine.”
This new cost information augments the other online decision support tools offered by Medica, such as a health plan coverage advisor; the Health Manager from Medica
SM online health management center that provides cash rewards to members who enroll and use it; the claims center where members can review claims and check the status of recently submitted claims; and access to BestTreatments, which helps members find out which treatments are the most effective.
The resource is available to Medica commercial members who have registered to use the myMedica® Web site (
www.mymedica.com). The tools available at the site include:
- Outpatient cost comparison tool. This tool provides actual cost ranges for nearly two dozen procedures at area outpatient facilities, including arthroscopy, carpel tunnel surgery and certain types of high-tech imaging tests.
- Hospital comparison tool. Members can compare estimated cost ranges, based on contracted rates, at selected regional hospitals for approximately 50 inpatient procedures including appendectomies, coronary bypass surgeries and hernia repairs. This tool also ranks hospitals by number of patients per year, average length of stay, complication rates and other quality measures. The tool allows users to create customized reports based on variables and rankings they select.
- Treatment cost estimator, which uses average costs in the user’s area to estimate out-of-pocket costs for diseases and conditions, surgeries and procedures, office visits and tests, and drugs.
About Medica
Medica is a 1.3 million-member health insurance company headquartered in Minneapolis and active in the Upper Midwest. The non-profit company provides health care coverage in the employer, individual, Medicaid, Medicare and Medicare Part D markets in Minnesota and a growing number of counties in North Dakota, South Dakota and Wisconsin. Medica also offers national network coverage to employers who also have employees outside the Medica regional network.
Medica has the highest accreditation status, Excellent, from the National Committee for Quality Assurance (NCQA®) for its Minnesota Medicare HMO plans and commercial health plans in Minnesota and North Dakota. Medica’s vision is to become the community’s health plan of choice, trusted for its integrity, respected for its service, and admired for its commitment to innovation and efficiency.
For more information, contact:Greg Bury, Medica
952-992-8437
Cellular: 612-810-4556
E-mail:
greg.bury@medica.com####