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Cost Groups
In addition to quality of care and service factors, cost is another important consideration when selecting a Care System. When you look at cost, look carefully, for highest cost doesn't necessarily mean highest quality.
At Patient Choice, we've collaborated with area health care providers to create a program that puts them in control. Instead of the adversarial rate negotiations process that occurs with other health care programs, Care Systems participating in the Patient Choice program determine their own pricing.
Based on the fees they set, combined with the effectiveness of the resources they use to manage their patients, Care Systems fall into one of three "cost groups". Cost group I indicates the lowest cost, cost group II falls in the middle, and cost group III represents higher costs. The amount you contribute towards your care is directly affected by the cost group the clinic/Care System you select falls into.
View Care System Cost Groups:
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2003
Quality need not come at a price
Doctors and hospitals are paid for every covered service they provide, but higher quality can actually help Care Systems lower costs. Care Systems that do the best job caring for their patients, such as keeping them healthy enough so they don't need to enter the hospital, avoiding infections and complications when hospitalizations do occur, and giving patients with chronic illness the tools they need to keep themselves healthy actually results in lower costs. For example, lack of diabetic control is costly-more trips to the ER, more hospitalizations for heart or kidney complications. Conversely, closely monitoring individuals with diabetes in an outpatient setting helps prevent problems and promotes early intervention, which saves money-and lives.
Costs can vary for many other reasons as well; operating expenses, facility costs, supplies, physician and staff salaries, and fees for specialty services are just a few examples.
But whatever the reasons, it's important to note that costs do not signify higher- or lower-quality care or service. Providers that deliver the best care, utilizing the most effective resources can pass along lower costs to the purchasers of health care--you and your employer. In other words, quality need not come at a price.
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