BEDFORD — A Bedford-based company is creating health care savings by helping members find out what services cost and offering incentives for choosing less expensive options.
“There’s nobody else in the country doing exactly what we do,” said Robert Graybill, CEO of Compass Healthcare Advisers. “We are unique in the market in terms on transparency.”
Graybill’s solution to health care shopping started by taking a different perspective on the nation’s health care system. He wondered why New Hampshire, which consistently ranks among the top three healthiest states, also topped the list in terms of having the most expensive health care premiums. He realized that the underlying cost of service was driving the cost of health care.
“We don’t have a health care problem in this country, we have a health care cost problem,” Graybill said.
Americans are generally smart consumers, Graybill said, but health care is a complex system that many find difficult to navigate. For example, costs for the same medical procedure can vary significantly at facilities that are near each other. Some facilities are cost-efficient in certain areas and high in others. Compass helps its members figure out what things cost and where savings can be found, Graybill said.
“Sixteen percent of the (gross domestic product) is running through a model where price has never been talked about,” Graybill said.
Compass Healthcare Advisers started in 2009 with three clients, a local municipality, a local school district, and the local state government. The company’s mission is to help consumers become better informed when making health care decisions.
The SmartShopper program is just that. Compass employees research the cost of a procedure, find providers offering that service in an area chosen by the member and let the member make a decision. Giving consumers tools to make an informed decision results in savings to the member, the employer and the taxpayers, Graybill said.
“We are designed to help Americans become more informed, smarter health care shoppers and, as a result, to bend the cost curve,” Graybill said.
SmartShopper saved $635 per use of the program in the first four months of 2014, Graybill said. A portion of the savings is passed on to the member using a tier incentive system.
For example, a member needing an MRI can go online or speak with a Compass Healthcare Advisor to find a list of providers in the chosen area. If the member chooses the Tier 1, or most cost-efficient provider, he or she will receive a $150 incentive. Choosing a Tier 2 provider results in a $75 incentive, and Tier 3 returns $50 to the member. The providers are in-network and fully credentialed.
“We take the confusion out of health care, and we’re delivering significant and measurable savings,” Graybill said.
The concept has proved effective in New Hampshire, and the company is now working with insurance providers and employers in eight states, Graybill said. He expect Compass Healthcare Advisers to double again this year. “We’re leading the way in the rapidly expanding transparency marketplace, and we have the results to back it up,” Graybill said.