Become a Healthcare Shopper

Unfortunately, medical care doesn't come in packages with clear price tags. Often, finding out exactly how much you'll pay to get the care you need requires perseverance and -- no pun intended -- patience.

The California HealthCare Foundation recently had a small army of "mystery shoppers" -- people posing as uninsured patients -- call or visit hospitals in the state asking for specific medical procedures. The mystery shoppers found that pricing information often resides with off-site billing personnel whom few hospital staffers could identify.

In more than 600 calls and visits, fewer than one-third of the mystery shoppers could get a firm price or estimate with a single inquiry. In an extreme example, one mystery shopper was routed to 17 different people before getting any pricing information.

The problem is not limited to California, nor is it something only the uninsured face. A survey by the Kaiser Family Foundation and USA Today found that 52 percent of people polled nationwide said their doctors never or rarely discuss the costs associated with the procedures they recommend.

What's more, employee benefit plans are raising deductibles and co-pays, forcing individuals to bear more of the burden of medical care. As this trend deepens, individuals will need to be able to compare prices before committing to medical procedures.

"People need to be better shoppers for health care because more of their health care costs will be paid directly from their pockets or will come from health savings accounts," says Maribeth Shannon of the California HealthCare Foundation.

Among other things, Shannon recommends that people get plenty of information from doctors before visiting hospitals. "It's important to have as much information as possible to help the hospitals identify what you need," said Shannon. "This way they can price procedures accurately." A key piece of information is the diagnostic code that doctors assign to ailments.

Shannon also recommends phoning the hospital before visiting. Mystery shoppers who called were able to get pricing information faster than those who visited.

Finally, Shannon recommends asking for discounts and payment plans to reduce costs and space out bills. "If you don't ask for a discount," she says, "it almost certainly won't be offered."

Blue Cross Florida opts out of Blues HSABank

Press Release:

Dec. 20, 2005

Prepared by BCBSF Public Relations

Blue Cross and Blue Shield of Florida (BCBSF) currently offers a variety of consumer-directed health plans including Health Savings Accounts (HSAs) and HSA administration and banking services through Mellon Financial Corp. The Blue Healthcare Bank, recently announced by the Blue Cross and Blue Shield Association (BCBSA), will be primarily focused on health-related savings accounts versus traditional banking services. Since the Blue Healthcare Bank won’t be fully operational for up to two years and due to the fact that BCBSF already has the ability to meet and exceed its customers’ needs with our existing relationships, BCBSF made the strategic decision to not participate in the establishment of the bank.

BCBSF carefully evaluated the offer made by the BCBSA to participate in the creation of the Blue Healthcare Bank. Although BCBSF offered to use the services of the bank to give BCBSF’s customers even greater financial options in their health care spending, that is not the bank's current business model. Any Blue plan using the services of the bank is required to become an investor. However, the current Blue Healthcare Bank offering states that non-investors will be able to join after a three-year period, and that is certainly an option BCBSF could exercise if deemed appropriate.

We will continually evaluate our options – without duplicating efforts – to ensure that BCBSF has the capabilities to help consumers understand health care costs and get the most value for their money, now and in the future.

If you have any questions about our decision, please contact your sales representative.

Missing Out on Benefits?

BenefitsCheckUp is the one of the nation's most comprehensive online service to screen for federal, state and some local private and public benefits for older adults (ages 55 and over). It contains over 1,300 different programs from all fifty states (including the District of Columbia). On average there are 50 to 70 programs available to individuals per state.

In addition to identifying the programs that a person may be eligible to receive, BenefitsCheckUp also provides a detailed description of the programs, local contacts for additional information (typically the addresses and phone numbers of where to apply for the programs), and materials to help successfully apply for each program.

BenefitsCheckUp was developed to address a concerning problem: millions of older adults are eligible for benefits, but not receiving them. Ranging from health coverage to supplemental income to help in paying utility bills, there are millions of older adults who could benefit from a wide array of public programs if they knew about them and how to apply for them.

Compare quality of care in Florida hospitals

When it comes to your health care, transparency of useful information is important. The Agency for Health Care Administration's (AHCA) consumer website includes performance data and information on selected medical conditions and procedures in Florida's short-term acute care hospitals and ambulatory (outpatient) surgery centers. This information is not designed to offer medical advice, and is only one avenue to assist you in making well-informed health care decisions.

Click on the link below to access the State of Florida site designed to access

Access the site by clicking here

YOUR GUIDE TO RECOVERING FROM WILMA

Many residents are left without power, closed schools and little to do besides pick up and sort yard debris, or stand in line for supplies. Cabin fever sets in, kids get rambunctious, ice becomes a quest. Here's how to stay safe -- and sane -- during the long recovery period.

Next time, be prepared
Wilma's winds may have departed, but now comes the modern family's real nightmare: No TV, no Internet, no cold soda, hot showers or, even more galling, reliable cell phone service.

Coping with stress: A guide for families
If the hurricane is gone but your psyche still seems to be as much in need of repair as your shredded home, you've got emotional stress.

Back to Basics: Utilities
Electricity

Return of power could be harmful
The return of electricity after a hurricane usually is a time to celebrate, but it also can be the start of a tragedy.

Stay safe during repairs
Many homeowners want to put their hurricane-damaged property back in shape quickly, and in most cases they can make emergency repairs without permits, building officials say.

Keep your food safe
Before you cook, assess the safety of your food. Toss out any food that may have come in contact with floodwaters. When in doubt, throw it out.

Water tips
Pay attention to local authorities about the status of your water supply. Use only bottled or disinfected water for drinking and cooking until the public water supplies have been declared safe.

Creative food ideas
Hurricane Wilma is gone, but we're a long way from normal. Food and food preparation is still a big problem for many.

Insurance numbers
Here are phone numbers, some of which are activated only after a storm, for insurance questions:

Filing a claim
Try to call your agent immediately. Most major insurers have toll-free numbers.

An insurance Q&A
Steps to follow when filing a post-storm claim
Q. Should I wait to see my adjuster before I start making permanent repairs?

Beware of dishonest laborers
Roofers, carpenters and trades people from around the country are heading to South Florida to help rebuild and cash in on a windfall. Most will be honest and qualified, some won't.

Be safe from looting
Looters can take advantage of the chaos in the days after a hurricane.

Avoid price gouging
A steady stream of price-gouging complaints for everything from inflated gas prices to jacked-up hotel rates have been filed with the state by those coping in Hurricane Wilma's wake.

Prevent mold: Get the wet out now
If your home was damaged by Hurricane Wilma, mold may be growing, and, in most cases, your insurance policy won't cover the cleanup. Experts say allowing the mold to grow can affect your health as well as your property values.

Dealing with a post-storm pool
After a hurricane, your swimming pool may be a haven for mosquitoes and a repository for debris. Here's how to remedy those problems:

House hints
Getting your house back to normal can help you get back to normal.

FEMA FAQs
Residents of Broward, Miami-Dade and Palm Beach counties have been declared eligible to receive individual financial aid from the Federal Emergency Management Agency. Here are some commonly asked questions about disaster assistance:

How you can help hurricane victims
American Red Cross, accepting financial contributions at www.redcross.org or mail to: American Red Cross, P.O. Box 37243, Washington, D.C. 20013. Specify Hurricane Wilma Relief. Volunteers are welcome at 6710 W. Sunrise Blvd., Plantation 33313. Call 954-797-3800 or 954-763-9900.

HMO's ranked by Adult Member Satisfaction

The 1999 Florida Legislature passed legislation that directs the Agency for Health Care Administration (AHCA or Agency) to publish a health maintenance organization (HMO) report card.

HMOs are required to report to AHCA data that are indicators of access and quality of care, such as measures of chronic disease management, preventive health care, and prenatal care.



For all indicators, five dots designate the best rank possible and one dot designates the lowest rank.

Commercial Health Plans	Ratings for Adult Member Satisfaction
New health plan (*) Not measurable/small population (**) Not reported (***)	Overall Plan Satisfaction	Ease in Getting to See a Specialist	Ease Getting Needed Care, Tests, or Treatment	How Well Providers Communicate with Members	Getting Help from Customer Service
Aetna Health, Inc.
AvMed, Inc.
Capital Health Plan, Inc.
CIGNA Health Care of Florida, Inc.
Citrus Health Care, Inc.	*	*	*	*	*
Florida Health Care Plan, Inc.
Great-West Healthcare of Florida, Inc.	**	**	**	**	**
Health First Health Plans, Inc.
Health Options, Inc.
Humana Medical Plan, Inc.
Neighborhood Health Partnership, Inc.
Preferred Medical Plan, Inc.
The Public Health Trust of Dade County/JMH Health Plan
Total Health Choice, Inc.
United Healthcare of Florida, Inc.
Vista Healthplan, Inc.
Vista Healthplan of South Florida, Inc.

EXPLANATION OF RATINGS AND DATA SOURCES

Health plan ratings are assigned for each indicator using benchmarks based on the overall distribution of results (scores) for all the health plans rated and the average score for the indicator. For each indicator, plans are assigned a rating as follows:

	1 or more standard deviations above the average score
	0.5 standard deviations above the average score
	Within 0.5 standard deviations (above or below) of the of the average score
	0.5 standard deviations below the average score
	1 or more standard deviations below the average score

If a health plan had a score exactly equal to a standard deviation benchmark, the health plan is assigned the higher ranking. For all indicators, five dots designate the best rank possible and one dot designates the lowest rank.

Descriptions of the data sources for the indicators used to rank plans are described below. In addition, results for each health plan showing their individual scores for each indicator are available in the Ratings & Scores section. The average score and a prior average, if available, are reported for each indicator.

Member Satisfaction

The University of Florida's Bureau of Economic and Business Research conducted a survey of health plan members on behalf of AHCA between October 2004 and January 2005. Members of commercial, Florida Healthy Kids, and Florida Medicaid health plans were polled by telephone to obtain a representative sample ³ A total of 12,619 surveys were completed. Adults were asked about their satisfaction with their personal health care. In a separate survey, a parent, family member or guardian was asked about their satisfaction with their child's care.

The indicators reported from the AHCA survey are:

• Overall plan satisfaction
• Ease in getting to see a specialist
• Ease getting any care, tests, or treatment that the member or member's doctor believed necessary
• How well providers communicate with members. This indicator averages responses to the following:
  1. How well do they listen carefully to the member?
  2. How well do they explain things in a way the member can understand?
  3. Do they show respect for what the member has to say?
  4. Do they spend enough time with the member?

• Getting help from customer service

Member satisfaction information for Medicare plans includes three indicators described above (overall plan satisfaction, ease in getting to see a specialist, and how well providers communicate with members) and two additional indicators from a survey performed in 2003 and reported on the national Medicare Compare website ⁴. The two indicators are:

• Overall satisfaction with care
• Ease getting needed care. This indicator averages responses about:
  1. Finding a personal doctor or nurse
  2. Getting a referral to a specialist the member wanted to see
  3. Getting the care the member and their doctor believed necessary
  4. Getting care approved by the health plan without delays