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Controlling Costs Topic of Discussion at PAT Council Meeting

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A representative from Tandem Care attended the monthly meeting of the PAT Council to provide an overview of how their health care price shopping service works.

Co-owner and nurse Lynne Painting described Tandem Health Advantage, a voluntary program that gives cash rewards to UNH benefits-eligible employees who make conscious decisions about where they choose to have outpatient medical procedures done.

The program is based on the often-times wide disparity between charges for identical tests or procedures. Painting cited the range between a colonoscopy done at Lowell Hospital in Lowell, Mass., ($970.) and York Hospital in York, Maine, ($2,890). In another example, she noted basic blood tests can cost as little as $111 and as much as $786 for the same profile.

The variance in pricing is because insurance companies negotiate a different reimbursement rate for each hospital or provider, depending on the procedure, Painting said. So, for example, Exeter Hospital gets paid about $13,500 for performing gallbladder surgery while Catholic Medical Center receives about $11,500 for the same surgery.

Comparisons can be made on the USNH Healthcost website (http://nhhealthcost.usnh.edu/default.aspx), which lists prices for many medical tests.

Using Tandem Health Advantage is simple. Just contact a Tandem nurse (1-866-797-4100 or info@tandemcare.com), compare prices, switch to the lower priced facility, if it works for you, and get a cash reward anywhere from $20 to $200, depending on the amount of the savings. (Rewards are taxable.) It can take up to 30 days to receive the money.

“As soon as the test is ordered, call Tandem,” Painting said, noting an appointment that is already set can be changed up to 24 hours ahead of time but not the day of the scheduled procedure.

She also added that employees should check with Tandem every time a medical procedure is recommended, and not assume the place they were referred to previously will be less costly. Prices are negotiated based on the test or procedure, not the hospital or clinic, Painting said, meaning a colonoscopy might be cheaper at same place that an MRI or other test is higher.

Amy Schwartz, director of Health Care Cost Containment for USNH, gave a brief presentation on cost containment. The university system spends $63 million a year on health care for its employees.