Charlottesville Insurance Crisis Tips, PART 3

Jordan Hackworth 11/23/2017

This is part 3 of 3. Part one & Part two cover cool stuff too, in case you missed them.

We’ve been talking about how big money has co-opted our health system in many real, sad ways. There are some healthcare groups, like ours, who see what is happening to our fellow

Surgical Technologists Julie Woodson and Latisha Hoge await the start of a new procedure.

Virginians as a tragedy.  Monticello Community Surgery Center is working hard to change health care by delivering a rational, honest approach that values transparency. That means honesty about our outcomes, satisfaction ratings and pricing. It is our belief that everyone should have the information they need to get the highest level of care for their condition and evaluate the associated costs for treatment before they receive their bill.  We are actively involved in health care reform on various levels.

One of our first actions was to reduce the bloated billing bureaucracy and offer transparent pricing. This means you pay one price, published on our website, for all of your surgery. surgeon’s fees, Anesthesiologist’s fee, facilities fee…all of it, included. 

8. Care in the Right Environment. 

Central Virginia has few choices when deciding where to get health care. We are lucky to have a thriving, academic medical center that delivers exceptional care in Charlottesville. For doctors visits, labs, etc, it may make sense to seek out high-quality, high-value care somewhere else. That is because academic medical centers can be among the most expensive places in the world to receive health care. There are numerous reasons for this. Partly, because they give so much charity care that other patients end up subsidizing them. They also deal with our state’s sickest and most complicated patients, who are very expensive to care for. Lastly, fees at academic centers support more than clinical care, they also fund education and research. While they are vitally important to our communities, choosing an academic center can mean much higher costs for everything from doctor visits and lab work, to minor surgery.  

Dr. Andrea Collins and Casey Jones implant a new intraocular lens after cataract removal.

Our community’s only other nearby option is Sentara, which purchased our community hospital in 2012. Optima, the only local health insurance company in the ACA market is owned by Sentara. So far this year, Sentara has netted over $484,000,000 in profit, a new record. Many big, consolidated health firms are making record profits, the likes of which have never been seen before. We know why the big price hikes we’re seeing might be necessary, to protect and feed that level of profit.

Looking around the state, big systems control large swaths of covered lives with little competition. HCA (one of the largest hospital groups in the country with a huge presence in central Virginia) reported profits of almost a billion dollars ($1,000,000,000) over the last 3 months alone, while families across the Commonwealth struggle with the decision to pay rent or for health care. Conglomerates have benefitted from policies in Washington that have driven tremendous industry consolidation. We’re allowing big companies to buy up small practices and hospitals so they can drive up prices for consumers.

There is a time and a place for all the types of care offered in our community. If you stick with independent providers, you can get more personalized care, better value and more importantly, avoid getting referred to the pricey in-house services of the big players.

Either way, if you need something done (even a specialist visit) it’s best to arrange a price first, before you commit. Consider getting lab work, imaging and other services from independent practices. The mark-ups on those services from large systems are huge, sometimes 2-10 times what you would pay at an independent lab like Quest or Labcorp. Be aware that choosing a primary care doctor from a big health system will undoubtedly cost you more, especially when you consider they will refer to their own system’s lab and imaging services, which are very highly marked up. It takes time to comparison shop and it is frustrating.  There are systems in place designed to make it difficult, but in the end, spending time on the phone may save you thousands of dollars. If you need surgery, there are many options– don’t be afraid to ask. 

MCSC is proud to sponsor the Charlottesville, Orange, Green and Madison County free clinics.

9. Free or Low-Cost Health Services.

Remember, there are numerous clinics, businesses and hospitals that offer free and low cost care. If you need surgery buy can’t afford it, please call us. Our center has donated millions in dollars in free or reduced cost surgical services for qualified patients. We want to help anyone who may need our services, whether they can afford it or not. Many other local providers do the same.

The Charlottesville Free Clinic offers free and low-cost medical and dental for those making less than 200% of the federal poverty line (currently less than $48,600 for a family of four). There are also free clinics in Lynchburg, Greene, Orange and Madison Counties. CVS, Sam’s Club and many other groups occasionally offer free health screenings including blood pressure measurement, cholesterol and glucose testing. There are resources for those making over the income limits as well. Sentara Martha Jefferson offers free mammograms to women over 40 without insurance. Region 10 in Charlottesville provides numerous health services for fair, sliding-scale prices, including adolescent care, mental health addiction services and even free acupuncture treatments for qualified adults.

Fight for your healthcare dollar. If you don’t the bureaucracy will snatch it from you.

10. Maximize What You Already Have.

Finally– look closely at your existing benefits, especially during this renewal period. If you have employer-sponsored care, don’t automatically renew your current plan. Benefits company Affleck reports that most American spend less than 20 minutes deciding on their health plan for the year. But it’s among the weightiest financial decision you make all year. Look carefully at what you’ve spent last year and what you plan on spending next year. Use the cost comparison tools in this article and consider paying with cash. Most plans include paid preventative services, vaccines and screenings. Make sure you’re not leaving valuable health services on the table.

These ideas aren’t fun or easy to do, but they’re what we ought to do if we’re going to turn around healthcare. The current system is not designed to benefit the consumer. It effectively hides the cost of services behind layers of a carefully built-up bureaucracy that is efficient at taking your money. Washington helped created the problem and they will never fix it without a radical reshuffling. Everyone, with and without insurance, must get smarter about consuming health care. Insist on quality, value, transparency and fair pricing. Thanks for reading. Questions? Please get in touch. If we can help, we want to.

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One comment

  • Robin
    12/07/2017 at 11:32 am

    There is another option for health insurance coverage, Christian health sharing. My husband and I are members of Samaritan we are in our 50s and pay $425 a month. Our deductible is $300.


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