Transparency Flash Tour
When deciding what products and services to buy, most consumers base their decisions on price and quality. Health care should be no different.
A day in the hospital costs an average of three thousand six hundred dollars. But the average consumer believes it costs only a little more than a thousand dollars.
As consumers take on more decision-making and financial responsibility for their health care, they need - and are demanding - the information to make the right decisions.
Aetna is doing its part to help.
Through its industry-leading health care transparency suite of tools, Aetna provides members with the information they need to evaluate the cost, clinical quality and efficiency for physicians in select markets. And Aetna provides cost information for common medical procedures performed at specific health care facilities.
This way, members can determine the value of their entire medical experience before services are performed.
Aetna's information on clinical quality and efficiency is based on the company's evaluation process for specialists. The process includes evaluating adverse events, thirty-day readmit rates, overall efficiency in the use of medical services, and the number of Aetna members treated. Aetna offers doctor-specific rates by specialty, for up to thirty of the most common medical services. These represent the actual negotiated rates for services, not just amounts for copayments or coinsurance.
In certain markets beginning November two-thousand and seven, Aetna will also provide facility-specific costs for over thirty common medical procedures. These will not be regional averages or estimates, but actual cost ranges for a specific facility. They will include the costs from admission to discharge, for the facility and the physician - and for ancillary fees, such as the services of an anesthesiologist. Common medical procedures will include colonoscopy, high-tech radiology, hysterectomy and more.
For both inpatient and ambulatory facilities, members will be able to search by procedure by location.
Because this information helps members calculate their costs before visiting their doctor or medical facility, it is especially helpful for members who have high-deductible health benefits or health insurance plan, or a plan with a Health Savings Account or a Health Reimbursement Arrangement fund.
Combined with Aetna's other member-focused, Web based tools, this level of clinical quality, efficiency and cost information helps members make more informed health care decisions and receive greater overall value.
To gain access to this powerful information, all members have to do is register on Aetna Navigator, Aetna's secure member website.
Go to "Find Health Care in DocFind®."
Members select criteria such as doctor location and specialty, and then click on the "Provider Detail" link next to the doctor's name.
They will see two features. "View Rates for Aetna Members" displays the doctor's negotiated rates for that member's health plan.
"View Clinical Quality and Efficiency" will reveal whether the physician has met the Aexcel evaluation standards for clinical performance, efficiency and number of Aetna members treated.
Once the member is registered with Aetna Navigator, they can also access Medical Procedure by Facility Cost information through "Cost of Care." This allows members to have access to actual costs of procedures by facility.
To search for the cost of a procedure by location, members can click the link "Compare Actual Cost Ranges by Facility."
They can select a procedure and can also select state, zip code, distance and sorting preference.
They will see the facilities within their area that perform the procedure, along with the actual range of costs.
Since cost ranges for both "Managing Physician" and "Facility and Other" are displayed, members view the total cost range from admission to discharge.
The link "Compare Hospital Outcomes" is just one example of other useful information available here.
Building a health care benefits system through which all Americans can receive optimal care, quality service and transparency of clinical quality and cost continues to be one of Aetna's top priorities.
We will continue to work with employers, health care professionals and legislators to help make consumers more informed about their health care.
Because at Aetna, we want you to know.
Health benefits and health insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc., Aetna Health of the Carolinas Inc., Aetna Health of Illinois Inc., Aetna Health Insurance Company of New York, Corporate Health Insurance Company and/or Aetna Life Insurance Company. *Health Savings Accounts and Health Reimbursement Arrangements are not available to IL residents.
Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Health benefits and health insurance plans contain exclusions and limitations. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Information subject to change. For information about Aetna plans, refer to www.aetna.com.
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