Controlling Health Care Costs – Anthem Shows the Way

The rapidly rising cost of health care is one of the most pressing issues that the U.S. is facing today and it is eating into the income gains of the average American family. The increase in health insurance premiums is leaving people with less cash to spend on other essentials. According a survey on employer-sponsored health benefits conducted by the Kaiser Family Foundation and the Health Research and Education Trust in 2010, premiums for single and family coverage rose over 9% since last year. The cost of premiums for families has risen from $13,770 in 2010 to $15,073.

Individuals are advised that maintaining a healthy lifestyle and choosing the right health plan can control the amount they spend on healthcare. And it’s really commendable when a leading health insurance provider comes forward to help members do this. With its history of financial stability, Anthem is showing the way with a slew of efforts to control rising healthcare costs for individuals, families, employers, and the nation at large.

Anthem Strategies to Rein In Health Care Spending

More costly technology, prescription drug costs and use, unhealthy lifestyles, unnecessary tests and procedures, and health care fraud are some of the main reasons for rising health care costs.

Premium break-up shows that private health insurer profits make up just 3% of the total amount. Up to 87% goes into medical services and products and the remaining 10% goes into paying for administrative services like claims processing, enrollment, billing, provider credentialing and complying with government rules. Anthem’s is trying to focus on all these aspects to help rein in costs: • Helping Anthem plan members save money on care: Anthem has developed two programs to do this – one uses Google Maps, an online tool and targeted outreach to help members avoid costly and unnecessary emergency room visits; the other helps members avoid high costs for services like MRIs and CT scans. Anthem negotiates with providers to get the best deal for its members and saves millions of health care dollars annually. • Measures to try and lower drug costs: Anthem has set up outreach
programs that aim to improve medication compliance and encourage the use of generic drugs when the doctor recommends them. Anthem is also working towards reducing harmful drug events and promoting the better use of medicines. • Programs to help members lead a healthy lifestyle: Anthem’s health assessment tool allows members to assess their health condition and take measures to reduce risk factors like obesity and smoking. Members with serious or chronic medical issues can manage their health with Anthem’s programs that come with 24-7 nursing care. • Promoting quality care: Anthem is fixing performance-based payment for doctors and thereby encouraging treatments that generally work. This health care insurer has special teams working to prevent, find and recover dollars lost to fraud. • Controlling administrative costs: Internal cost control measures that Anthem is adopting include investment in efficient technology to streamline claims payment, help reduce costs and improve customer service. These measures are aimed at controlling customers’ health insurance premiums.

The effects of Health Care reform could vary between individuals, with some paying more and others less. Nevertheless, Anthem’s attempts to lower health care costs set a laudable example for the health insurance industry.