Six tips on managing health care costs

Health care costs are a financial burden for many Americans. A survey from West Health and Gallup found that Americans in large numbers are borrowing money, skipping treatments and cutting back on household expenses because of high health care costs. The survey of more than 3,500 adults found that 45 percent fear a major health event could bankrupt them.

“If you look at public records today, the number one cause of bankruptcy in the United States is health care costs,” says Paul Ketchel, CEO of MDsave. “If you look at health care spending in general and as a percentage of household income, it’s one of the highest items if not the highest item for most families and individuals.”

Ketchel says there are six things consumers can do to lower their health care costs:

Use transparency tools to compare prices

The West Health and Gallup survey found that 47 percent of people are never aware of how much they will pay of pocket when they go to the emergency room. Fully 21 percent do not even know how much they will pay for a checkup or a physical. If you are going to have a health care procedure, Ketchel advises consumers to research the cost before walking into the provider’s office or deciding to move forward. You can do that by using transparency tools - websites that help you compare the cost of health care services.

“It’s a lot like if you went to the car dealership and bought a car,” he says. “When you drove off they said I hope you like that car. In three months or so, we are going to send you a bill and tell you how much that car cost.”

Ketchel says driving a few miles out of your way can make a big difference.

“If you look around the country today in the local market, there’s about 300 percent price variation from provider to provider for the same procedure with no difference in quality or outcome,” he says. “If you look at the same procedure on a national view, there’s a 750 percent variation for the same procedure.”

Stay on top of your preventative care

Ketchel says a little bit of preventative maintenance can go a long way in reducing your financial costs and improving your health care outcome.

“A simple example might be a colonoscopy once a year,” he says. “That is often paid for by your health plan under the Affordable Care Act. If not, there are transparency options that you can get those for $1,500 or less. If you can catch that early at $1,500, you might not only have a better health outcome, but your costs could be a few thousand dollars. Whereas, if you catch a disease condition like that in a later stage, it could cost tens if not hundreds of thousands of dollars.”

See the right kind of doctor

If you’re like most people, Ketchel says you don’t have a primary doctor. He says that’s why many of us are not having our annual checkups. Instead, we are visiting urgent care or walk-in clinics.

“This is a good treatment option from a cost-sensitive standpoint if you have a cold or the flu,” Ketchel says. “But you are really losing that connection to the provider. In the past, primary care providers were the ones who would do that preventative check on you and then refer you to the proper specialist. It’s important to see a provider that sees a large bulk of the type of complications you are having.”

Save the emergency room for emergencies

Emergency rooms are designed for emergencies. Ketchel says there’s no place where consumers overpay more for health care than an emergency room visit.

“They are staffed with emergency physicians,” he says. “There’s a certain process they have for giving care. They are designed to treat complicated issues that are time sensitive. Going to the emergency room for ordinary care is like consuming extra health care you don’t need.  Because there are specialists working in the emergency room, those rates are significantly higher.”

Ketchel says that emergency room visit can cost you 10 times as much for the same exact service.

“You may have a cold or a cough and there may be an emergency room you can walk to down the street,” he says. “In that example, you are going to have an emergency room visit that could be ranked as a level three emergency. That may be $800, $900 just for that checkup and visit. The same exact visit could be performed at an urgent care or a walk-in clinic for $99. “

Take advantage of covered preventative care

In order to be licensed in most states, the Affordable Care Act requires insurers to provide consumers with a list of mandated coverage requirements. Ketchel says that could include a diagnostic colonoscopy if you are over 40 or an annual mammogram.

“What you’ll find is that there’s a lot of preventative care at no cost to you for you to utilize,” he says. “You are paying for that care because it’s built into your insurance premium. It’s coming out of your paycheck each week.  If you don’t use that preventive screening, you are paying for something you are not using. It’s not only good to help you reduce costs; it’s also good to manage your health.”


If you are unsure what preventative care is covered, visit the website of your health plan or call the 1-800 number on the back of your card.

Don’t rush to pay health care bills

If you start receiving multiple medical bills for a health care visit, Ketchel says don’t rush to pay it right away.

“Wait until you have collected all of the bills,” he says. “Review them. Call your provider’s office. Have them walk you through each one of those bills to ensure everything is correct. In the United States, 90 percent of medical bills are inaccurate. If you are writing that check, there is a good chance you are overpaying for something you may or may not have received.”

Linda Bell joined FOX Business Network (FBN) in 2014 as an assignment editor. She is an award-winning writer of business and financial content.  You can follow her on Twitter @lindanbell