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Anthem Pilots Cost Estimation Tool

Anthem Blue Cross and Blue Shield launches an online tool that breaks down the cost of medical procedures to enable consumers to make informed decisions about their health care spending.

Anthem Blue Cross and Blue Shield in Ohio, a subsidiary of WellPoint (Indianapolis; approximately $50.1 billion in assets) is piloting on an online tool that estimates the costs associated with medical procedures performed at local area hospitals. The tool, designed to help inform policyholders about the cost of healthcare, also helps members better manage their flexible spending accounts and consumer directed health plans.

"The savings will be dependent upon how particular members use this tool. It is packaged for all of our members to allow them to access information easier," says Rich Gunza, executive director of Anthem in Dayton.

The Anthem CareCompare pilot will allow more than 300,000 policyholders in Dayton, Ohio to see a breakdown of the costs associated with 38 different procedures-- including hospital costs, physician costs and anesthesia costs-- before they receive the medical service. "We are really concerned about the affordability of healthcare and we wanted our members are actively involved by giving them information," comments Gunza.

The online site was created after Anthem customer General Motors (Dayton), asked the carrier to come up with a Web site that would increase employees' awareness of costs of medical procedures and enable them to make informed comparisons. To create the site, in February of 2006, Anthem ran a claims history on its data warehouse, and identified the most frequently used medical services. "We identified 300 common services and chose 38 of the most popular procedures and pulled the data and summarized each procedure with the prices," says Marilyn Silver, information manager for Anthem.

After three weeks of running data that summarized each procedure and identified the ranges of services and prices at each hospital, Anthem partnered with Subimo (Chicago) to develop the Website.

Anthem is working on the second phase of the pilot and hopes to go live with Anthem CareCompare nationwide in early 2007.

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