Knowledge is power. It’s an old, and somewhat cliché, adage, but extremely relevant when it comes to navigating today’s healthcare ecosystem. Why? Because health care is confusing. A 2017 UnitedHealthcare report revealed that only 9% of consumers were able to define all four basic insurance concepts outlined in its survey: insurance premium, deductible, coinsurance, and out-of-pocket maximum. If these findings suggest that more than 90% of today’s employees do not grasp basic insurance concepts, how are they supposed to select the right health plans, procedures, and treatments?
This presents a huge problem for employers who offer health benefits. Increasingly, employers are offering consumer directed or high deductible health plans. They assume their employees will shop around for care in the same way they might shop around for a new car—seeing what meets their needs at the best possible price. But this isn’t happening.
Most employees, as DirectPath has established, don’t understand health care, nor do they know how to identify and use resources that can help them make more-informed decisions. As a result, they base their decisions off of what comes recommended by their doctors, friends, or family members.
While all these groups could be well-intentioned, they likely do not know the employee’s full story—such as their unique medical needs, their spouse’s benefits package, or what other in-network providers might be more cost-effective. Essentially, what we all too often have is the blind leading the blind.
Blind decisions can easily yield higher-than-needed healthcare spending—for not only employees, but for the employers sponsoring their insurance, as well. To prevent high healthcare costs, employers need to find ways to better educate their employees so they make informed decisions when it comes to choosing the right treatments. Cue the rise of healthcare transparency.
Through healthcare transparency, employees can better understand cost and quality information for treatments they might need. Costs for the same service can vary widely amongst providers—the same knee surgery might be quoted anywhere from $33K to $100K—so it’s imperative that employees understand these discrepancies before moving forward with a treatment. This information may come in the form of a cost-comparison report, it may be found online, or it may be shared through a direct exchange with a healthcare advocate.
Regardless of how the information is delivered, having some sort of transparency service in place will help employees make more informed, cost-savvy decisions—which mean lower out-of-pocket costs for them, and reduced healthcare expenditures for their employers.
Establishing a Transparency Service
How can employers effectively roll out their healthcare transparency programs? Here are five tips:
- Proactively engage employees about the program. Go beyond the one-and-done e-mail and consider ways to instill the program information in their heads. HR teams might consider a “lunch and learn” session to teach employees about the new offering or send regular reminders about the benefits of using transparency services.
- Showcase the savings. People respond to data, so be upfront about how they can save big by taking advantage of transparency services. Whether it’s at the “lunch and learn” or through another forum, make it clear how much can be saved, and emphasize that higher quality does not always require a higher cost.
- Take advantage of all the channels. Add information about the transparency program to employee portals, and share updates and alerts regularly via text, call, webinars, and posters.
- Get personal. In addition to group sessions and webinars, HR teams should consider one on one meetings, during which they can explain how various treatment options might play out given an individual’s plan, network, location, and specific service.
- Empower employees to apply what they’ve learned. Once employees understand how to obtain and compare costs for health services, encourage them to put their knowledge into practice—perhaps calling pharmacies to get the best price for their prescriptions or asking their doctors about costs.
By investing in a transparency program, and highlighting its value to employees, employers will be able to cultivate an informed, healthcare savvy staff. And if knowledge means power, organizations that embrace healthcare transparency will dominate.
|Bridget Lipezker is the Senior Vice President and General Manager of Advocacy and Transparency at DirectPath. She has a demonstrable track record of delivering customer satisfaction through consistent on-time implementations that produce measurable operational results.
Prior to DirectPath, Lipezker led the HighRoads professional services team to develop and improve implementation methodology to ensure optimal product adoption. Before that, was a senior manager in the Deloitte Consulting Human Capital service area where she provided strategic solutions to global and national clients facing transformational change and complex business opportunities related to globalization, intense regulatory environments, and health care reform.
Lipezker holds a Master of Science in Business Administration at the University of Illinois at Chicago, and a Bachelor of Science in Public Administration at Indiana University Bloomington.