An Anthem Blue Cross and Blue Shield pilot program under way in three states aims to determine whether cash incentives offered by employers can move healthcare consumers to select low-cost facilities for medical care.
Smart Shopper is being piloted by self-insured employers in Connecticut, Indiana, and New Hampshire by Anthem Blue Cross and Blue Shield. The on-line program is offered as part of health insurance benefit packages and is voluntary for employees.
Chris Ulbrich's family-owned stainless steel and special metals manufacturing business in North Haven, CT has about 300 employees participating in the Smart Shopper pilot. The company pays about $7 million annually for health insurance benefits. "We've cost-shifted about 25% to our employees but we were looking for other ways to trim our expenses when this program came along."
Based on 2010 utilization Ulbrich's company expects to save about $160,000 on medical services during the one-year pilot. That includes any incentive payments and the administrative costs of the program. "At that rate in six years we'll save almost $1 million. That's money we can invest in the business and our employees," said Ulbrich.
The program targets more than 35 high volume procedures and tests, including: ACL repair by arthroscopy, cataract removal, colonoscopy, computerized tomography or CT scans, hysterectomy, knee arthroscopy, mammogram, MRIs, sinus surgery, and upper GI endoscopy.
Smart Shopper works a bit like the Priceline service for booking hotels and airlines. When a physician recommends a medical service or diagnostic test, the patient logs onto the Smart Shopper site and enters information about the prescribed services and the zip code where the service will be supplied.