Price transparency and medical insurance

Updated: Sep 2, 2020

Standard health insurance is unlike any other insurance you buy: Even after you pay premiums, there are complicated out-of-pocket costs like deductibles, co-pays and co-insurance. If you fall ill or are injured and don’t know how health insurance works you could become one of the millions each year who are caught off guard by high medical bills.

​​In just the past ten years families nearly doubled their spending on health care. The complex ways in which Americans paid for health care obscured how this happened. Americans year over year have been faced with higher and higher healthcare costs, facing higher and higher obligation to pay for those out of their own wallets without information around the price and the quality associated with their medical services.

What families got for spending nearly twice as much for health care:

  • A smaller increase in life expectancy compared with other developed countries.

  • More-frequent use of costly health care technology including imaging tests of questionable medical value.

  • Less-effective treatment of curable ailments with the U.S. dropping from 14th to last among 16 developed countries in preventing death from treatable conditions.

Deductibles don’t work. They haven’t and they won’t. Deductibles inflate cost of care, obscure health care cost, fail to save you money and promote ill health.

ValiseMD® Membership Care™ brings you leverage against today's broken health insurance. Your personal control of health care empowers you to improve your health and improve your bottom line.

So, what does ValiseMD® Membership Care™  look like? How does it work? 

If everyday consumables were priced like health care, your morning latte from the coffee shop will cost between $5 and $500 but you won't know the actual price until your “explanation of coffee benefit” arrives in the mail weeks or months after you drank it.

Thanks to coinsurance, deductibles and obscurity of health insurance cost you drank a $500 dollar latte advertised for $5. You find out what you owe weeks after you consume care, especially super urgent care. You also unwittingly learn one of many lessons in The Book of Swindles written and compiled by Zhang Yingyu during the Ming Dynasty.

Why not pay $25 for your latte just for security of knowing you won't get billed $500 and risk collections? And, instead of driving across town for your latte why not have it delivered to you?

ValiseMD® Membership Care™ is transparent, concise and clarifies consumption and cost. The $5 latte costs $5, tax included and delivered! With incentive and clarity you avoid ever rising deductibles completely. You adjust coverage when your needs change. ValiseMD® Membership Care™ gives clear price signals you need during treatment and the tools to make informed decisions.

ValiseMD® Membership Care™ gives you opportunity to pay less for treatments more likely to work. You are treated at home, not inside a hospital facility where costs skyrocket quickly out of control.

ValiseMD® Membership Care™ explains cost and quality in crystal clear language, never obscured nor hidden behind health insurance plan deductible slight of hand.

I know what you’re thinking; a health membership that encourages members to get care? How do I sell that to my family?

It’s not as radical as you think. Just ask Uber, Netflix, or Amazon. 

A century ago in the United States, most doctors were paid directly by their patients and fees were clearly stated or negotiated in advance. Health insurance was reserved for serious hospitalization. Hospitals are now charging the privately insured 2.4 times what they charge Medicare patients. Normally contracts between insurers and hospitals are closely guarded secrets; hospitals don’t want anyone to know about anti-competitive practices and pricing strategies often embedded in these contracts. Insurers have convinced themselves that negotiations with hospitals are trade secrets giving them an advantage against competitors.

Hospitals, drug companies, and other health care industries keep raising prices knowing that patients are several middlemen removed from the cost and value of the care they receive. 

More than likely the doctor office, urgent care and stand alone ER in your neighborhood is organized with a hospital and negotiated a deal with your insurance plan and can do bewildering things with your out of pocket costs. Even more confusing is how hospitals form their own alliance with physician groups who are then granted immunity from insurance contract limitations. The net result is the $500 dollar latte advertised for $5. If you cannot afford the latte, it's too late - you already consumed it and can't return it.

Ascension Health's ties to embattled deb
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Christian based 'charity' hospital systems may show you the back door and throw you to collections when you pay them twice the true cost of your latte ($5) and choose to buy groceries or pay rent with what savings you still have.

Ascension invests in Accretive Health, h
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Hospital and medical insurance network agreements offload implied social contracts between doctors and needful patients and at the same time lock patients in a system of profit.

Patients should be able to know, long before they apprehensively open a medical bill, roughly how much it will cost to receive care at a hospital owned facility. But what we take for granted in countless other commercial contexts—that consumers can find out the price of goods or services before they make a purchase—is lacking in the market for hospital services. As a result, patients frequently are caught off-guard by hospital charges; they struggle to figure out where they could receive more affordable care; and the market forces that would otherwise keep healthcare costs down are stifled.

Re-evaluate options you are utilizing for your health. ValiseMD® Membership Care™ empowers you to improve your health and improve your bottom line. Buy a plan, book a service, we'll drop by so you can heal at home.

ValiseMD® welcomes all private insurance, self pay plans, Medicare and Tricare.

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