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The recent healthcare reform legislation passed in Massachusetts includes provisions for increasing the transparency of prices for procedures, office visits and diagnostic tests for consumers. Harvard Vanguard supports this transparency and is committed to improving the quality of care while lowering the cost of health care in a responsible way. We recognize that it will take effort and time on the part of both the health plans and providers to provide meaningful information for making healthcare choices. Martha Bebinger of WBUR recently put this transparency to the test and highlighted her research about an MRI that she had scheduled.
Here are some general approaches and principles that can assist you in lowering the cost of your care, typically with the same or improved quality and often in a more convenient way:
- Get care in your primary care office if possible before seeing a specialist.
- Avoid the emergency room for non-emergency care. You can access medical advice and some treatment options 24 hours per day 7 days per week, 365 days per year by calling your primary care doctor’s office. Harvard Vanguard practices work hard to be able to offer same day appointments for urgent issues. During the hours when our offices are not open, Harvard Vanguard provides free telephone advice from nurse practitioners and physician assistants who have access to your electronic medical record and who may be able to write a prescription or schedule a visit for you. Harvard Vanguard has practices open for weekend and holiday urgent care 365 days per year.
- Avoid medically unnecessary tests and procedures. If in doubt, ask the clinician “Why is this needed? How will this change the treatment I am likely to receive? What will happen if I do not receive this test or procedure? Are there other options that might be more cost-effective that we can try first?”
- Medical societies from a number of different specialties have created their “Top 5” lists for avoiding unnecessary tests and procedures, and you can find them at Choosingwisely.org.
- If selecting a test or procedure, while there are exceptions, it is usually least expensive to most expensive in this order: Freestanding or physician group independent of a hospital, hospital outpatient clinic, community hospital, academic medical center. If the hospital name is on the door of an outpatient clinic that is within 30 miles of the hospital, the hospital is allowed to charge the same facility fee that they would charge for a test or procedure done in their hospital.
- Look for opportunities to ensure that your care is coordinated through your primary care physician. This means talking with your physician about his/her preferred hospital and specialty partners. Harvard Vanguard is working with its partners in the community to increase coordination and improve transitions of care. For you this can translate into fewer appointments, less duplication, less likelihood that something important will go undetected, and improved medication management. Coordinated care has been shown to be higher quality and less expensive.
- You can often avoid having tests unnecessarily duplicated if you go to facilities that have the same or connected electronic medical records so the clinician can see what has previously been done. The Atrius Health medical groups connect electronic medical records to each other and many of our hospital partners where possible.
- Sign up for MyHealth Online, our free online patient portal where you can send a secure e-mail to your physician’s office for non-urgent medical issues. You can also access information about lab tests, see prior and upcoming appointments, check your health problem list, and request prescription renewals. There is even a mobile app for iPhone and Android for users of MyHealth.
- Quit smoking. It’s one of the best things that you can do for your health, it will decrease your risk for illness later on, and it will save you money starting immediately.
- Utilize generic medications where possible. Only for use by Harvard Vanguard patients, the 14 Harvard Vanguard pharmacies are often less expensive for both prescription and over-the-counter medications.
- Finally, if a clinician suggests a care plan that you cannot follow because of the expense, speak up so that you can investigate alternatives and/or look for programs for which you may qualify such as Prescription Advantage.