Among the best evidence that our health care system is broken is the fact that providers bill wildly different amounts for treating something as minor as a cut: at one hospital it can set you back the price of an iPad; at another it’s more than the cost of two Peloton bikes. In fact, emergency rooms in the U.S. charged as little as $629 all the way up to $5,751 for a very similar visit.
Why is there so much cost variation in our health care system? In theory health care prices should be a simple formula: the cost for a certain type or unit of care (for example, an x-ray, or a new patient visit), multiplied by the units of care providers use to treat the patient. But it’s not that simple. Providers vary considerably in the type and amount of care they provide. If, for example, a patient with back pain visits a provider, the type of imaging, physical therapy, and even whether surgery is performed varies greatly based on which provider they see. The cost per unit also varies widely according to rates negotiated with different plans and the amount of power an institution has.
And unlike many other goods and services, paying more for health care offers no guarantee that you’re getting better quality — plenty of institutions are expensive without offering better health outcomes. What’s more, the process of finding the right provider for your needs is too complex: everything from price variation, to quality factors, to inaccurate provider directories makes it extremely difficult for individuals to get the care they need without a guide.
Helping employers and their employees navigate this inefficient and variable system is one of the reasons we created a new health plan solution. At Centivo, our mission is to bring high-quality health care to the millions of Americans who struggle to pay their healthcare bills. We offer self-funded employers a way to save 15 percent or more versus traditional health plans and provide their employees with coverage that offers affordable care and delivers a great experience.
Lowering costs, however, isn’t our only goal. We also want to help ensure that more people can meet their health needs and get quality care. We accomplish this by building transparent, local networks of the highest-value providers from the ground up, and then guiding members to primary care physicians who will act as their main point of care and help them navigate the health care system, all within the network. We don’t include every provider in our network, and we’re loud and proud about it.
At Centivo, we can build win-win partnerships with health systems and health care providers by bringing them desirable business and paying them for value. Providers are looking for three things: how can they acquire more patients, how can they acquire more desirable patients, and how can they collect on more of their bills? We take advantage of those drivers for the benefit of our clients. Because we only work with self-funded employers, not only are we bringing providers more volume, but we bring them members who are employed (younger and healthier than the general population), and with our plan design (no deductible, low copays), they can take on considerably less bad debt risk. In addition, we pay incentive bonuses for doing the right things for patients, like coordinating their care, increasing access, and more. Finally, providers can get paid to add value in a way that a fee for service model doesn’t capture.
By choosing Centivo, employers can save money, access high-quality provider networks, and help keep their employees healthy and happy. Visit us at centivo.com/employers to learn more about our health plan that works for hard working Americans.
Ashok Subramanian Founder & CEO
Ashok founded Centivo in 2017 after observing the inefficiency in the healthcare system and the pain that has resulted for employers and employees.
