This month’s newsletter is devoted to various resources available to self-pay patients, to showcase some existing and newly emerging self-pay service models, and to show that such successful models are being copied nationally. Remember that Medical Cost Sharing is open access and that members are not required to use these new models. However, as members of a sharing community, it's in everyone’s interest to secure high quality, low cost services so that all members of the community, including the member, benefit.

This monthly newsletter contains information about medical cost sharing programs as well as health insurance plans offered through insurance companies that promote healthcare cost transparency. It provides information about tools designed to maintain or regain your health, articles on health and wellness, and information on complementary and integrative health. It also contains information on other cost-transparent products and services you can purchase or utilize to supplement either your medical cost sharing program or your insured health insurance plan.

One of Health Excellence Plus's objectives is to introduce transparency into healthcare pricing so that members know what services cost before they actually utilize them. 

The Becker Hospital Review’s Hospital CFO Report is one of the most valuable sources of information on the actual cost of hospital services. The most recent data are from 2013 and reported by Kaiser Health Facts in 2015. The most currently-available report shows costs per inpatient day in 2013, organized by hospital ownership type, in all 50 states and the District of Columbia, according to the latest statistics  from Kaiser State Health Facts. 

Note: The data includes all operating and non-operating expenses for registered U.S. community hospitals, defined as public, nonfederal, short-term general and other special hospitals. These figures are not a substitute for either actual charges or reimbursement for care provided. They are an estimate of expenses incurred in a day of inpatient care and are adjusted higher to include an estimate of the volume of outpatient services.

Read the state-by-state comparison here .   Even if you make an assumption for hospital cost inflation, these average numbers are considerably lower than traditionally-reported hospital health costs. Insurance carriers and medical cost sharing organizations obtain considerable discounts from what hospitals bill for services. But these figures prove that hospital bills are highly inflated and contain room for considerable discounting. Sedera obtains discounts for all members who have Needs that equal or exceed $500.

The Oklahoma Surgery Center has been identified in the last several years as the model for low priced, high quality surgery services. True to the tenets of self-pay, they post their surgical fees on their website.

Individuals from all over the country are traveling to Oklahoma City to have surgery performed at the Center because of the high quality and low pricing.

When I was at the Freedom Fest Conference in Las Vegas a couple of weeks ago, Charles Sauer, author of a new book titled Profit Motive , told an audience in a session sponsored by Health Excellence Plus that he's identified a significant number of other surgical centers throughout the country. I'm in the process of identifying such centers, as well as the services they perform, and will be publishing information about them in the next issue of this newsletter.

Sedera, the administrator of the Medical Cost Sharing program for the Health Excellence Plus healthy care strategy healthcare programs, supports the concept of medical tourism. If you’re a member and need surgery, you should speak to a Sedera Medical Advisor to determine if they'll recognize additional expenses (e.g. traveling to one of the centers) as shareable (as well as possibly reducing your Individual Unshareable Need for that specific condition under the Program) if going to an out-of-area surgical center reduces the cost of expenses otherwise shareable by the community if you have that surgery performed locally.

The Sedera program also utilizes the 2 ^nd MD second opinion program and reduces your Individual Unshared Amount (IUA) by $250 for using the program. 

If your physician and the second opinion doctor (these are all specialists from world-renowned medical institutions) disagree and you want a third opinion, you can utilize a third doctor at your expense, and the opinion of two of the three doctors will be considered the second option. Through use of this program, a large number of members have found they're able to avoid costly elective surgery.

Green Imaging in Houston is pioneering how MRI’s, CT scans, and other imaging procedures can be provided at very low costs (as low as $250 for an MRI) on a self-pay basis.

Green Imaging is a full service virtual medical imaging network owned and operated by a group of board-certified radiologists. They help patients make the most informed decisions about  MRIs , CT scans, and other imaging procedures. Unlike other imaging facilities, the cash-pay price they provide is the final price the patient pays. There is no extra charge for the radiologist fee.

You pay for your procedures up front, with no surprise bill after the fact .

Green Imaging is the first imaging network we’ve identified that works on the self-pay concept. They have a number of locations in Texas, and their model will certainly be copied by other radiologists. One of the ways they’ve been able to lower costs is to contract with imaging centers and other facilities so they can provide services during low utilization periods.

See their website for more information .