By Dr. Josh Luke, faculty member
University of Southern California’s Sol Price School of Public Policy

Has your business or startup made a major purchase only to find out later you overspent significantly? How often are you making this same mistake with healthcare? Moreover, it’s likely that your employees are making this mistake every day, yet they may not even know they have an option. Unless you, as an organization, take ownership of educating your workforce, it’s likely your employees will continue to overspend. And remember, if they are overspending their own money, then you can multiply that by three or four times for its financial impact on the company. For example, a simple surgery can cost your company $30,000 to $40,000 more if the employee does not choose a center of excellence.

It’s very common that one hospital will charge 60% more for the exact same procedure as a competing hospital, often located directly across the street. To confuse this process even further, would you believe that the same exact doctor will operate on you at either of these hospitals? This is what happens when you are led to believe “your insurance will pay for it.” These are the six words that killed American healthcare.

Your insurance will not pay for it

When you buy a new car, do you compare features and price? When you buy a house, do you shop neighborhoods, school districts and number of bedrooms? Of course you do. Why don’t you do the same when it comes to your personal health? Why are Americans afraid to ask a doctor for a second opinion – or even an alternative – when a high-cost procedure is recommended?

Well, the short answer is that we have been led to believe that our insurance will cover the costs so it’s not important. We don’t monitor which facility we choose, and we don’t question recommended procedures. But, that’s dead wrong. Each time an employee chooses a higher-cost provider, that cost is added in some form to the following year’s premium cost to your company – which, in turn, is passed on to you. Year after year. It’s inflation by design! Not your design, but by the hospitals, insurers and pharma companies (among others) that benefit from constantly increasing prices.

Become an EHC

It is critical that individuals become Engaged Healthcare Consumers (EHCs). How? Start by focusing on the three P’s: Plan, Prevent and Personalize. Create a strategy that focuses on preventive care as well as personalized care.

P#1 – Have a Plan: The first P is to take control of your health by creating a healthy living plan. That plan includes your dietary goals, as well as fitness and lifestyle habits. Also, if you suffer from a condition or chronic disease that impacts your health, your plan should include specialized steps to specifically address those needs as well. Your plan also should include several personalized and preventive medicine steps.
Update your plan at least annually, but daily monitoring and tracking of diet and fitness habits are critical in shaping this plan as well. There are plenty of tools available via mobile phone application to track both diet and fitness. Also, research mobile applications available to support you in disease management efforts for any chronic diseases you may have, such as diabetes or hypertension.

P#2 – Personalized Medicine Tactics: A number of personalized medicine tactics should be considered, including DNA testing and genome sequencing, as well as functional and integrative medicine tactics. The more you can learn about how your body differs from others, how your body metabolizes medication and food, and how your body reacts in general to different foods, exercises and lifestyle habits, the healthier you will be. Implement these tactics into your plan!

P#3 – Preventive Medicine Tactics: The second key component of your plan is to utilize the tools, resources and technology available to assist you in monitoring and improving health. From checking your blood pressure to diabetic management to tracking exercise and dietary consumption, a healthy living plan is the first step in practicing preventive medicine tactics. It’s only a matter of years now before science will identify the exact medication that is best for your condition based on your personal metabolism, known as polygenic risk scoring. At present, we are well on our way to that level of personalization, so utilize the tools currently available.

To date, there has been little evidence suggesting any link between price and quality in healthcare. In fact, those doctors who engage in the discussion about fair pricing often are getting higher quality scores than the high-cost provider. The doctors and facilities that offer lower pricing and higher quality are known as centers of excellence, often referred to as within the narrow network. Once you begin your journey to becoming an Engaged Healthcare Consumer, continue by shopping for healthcare Centers of Excellence. This will save significant dollars for both you and your employer.

So, while corporate America has finally stepped up to lead the charge against hyperinflation in American healthcare, individuals can do their part by becoming Engaged Healthcare Consumers. The tactics listed above are simple and will start you down your EHC path.

Dr. Josh Luke is a celebrated speaker, award-winning Futurist, a faculty member at the University of Southern California’s Sol Price School of Public Policy and the author of Health – Wealth: 9 Steps to Financial Recovery. Drawing on his experiences as a hospital CEO, Dr. Luke delivers engaging and entertaining keynotes that teach audiences simple concepts on how individuals and companies can save thousands on healthcare. For more information, visit www.DrJoshLuke.com.