MedCity Influencers, Health Services

How Covid-19 has enhanced the need for price transparency

Price transparency is no longer a nice to have, it’s a must-have as consumers’ wallets increasingly run dry.

consumerism

The financial strain on Americans has been one of the largest impacts from Covid-19. Many have found it difficult to pay for certain necessities and nearly half (47%) of Americans age 18-64 are more concerned about the cost of healthcare now than they were before the pandemic.

This issue of healthcare costs is not new but has become exacerbated due to Covid-19 and a bigger topic of conversation as the 2020 presidential election approaches in November. For years, the cost of medical care in the U.S. has been a deal-breaker for many and four in ten claim they have been unable to pay a medical bill. Surprise bills, high deductibles, confusing terminology and plans, as well as not knowing where to find pricing for care, all culminate in consumers running an obstacle course to find safe, high-quality, affordable care. Price transparency is no longer a nice to have, it’s a must-have as consumers’ wallets increasingly run dry. Coupled with offering price transparency is the growing need to communicate to consumers where to go to find healthcare pricing information.

What Is HealthCare Price Transparency?
According to the HFMA Price Transparency Task Force, healthcare price transparency is defined as “readily available information on the price of healthcare services that, together with other information, helps define the value of those services and enables patients and other care purchasers to identify, compare and choose providers that offer the desired value.” However, I define it even more simply – informing consumers on what their anticipated out-of-pocket cost will be for seeing a specific provider at a specific location for a specific procedure, whether they are online or over the phone. Consumers can shop for everything else in their lives—food, clothes, appliances, cars—and know the exact price they are going to pay before they purchase. They can price compare to ensure they get the lowest price for the highest quality item they are looking to purchase. This process should be commonplace in healthcare too.

We are starting to see more legislative attention around price transparency, including the Trump administration’s price transparency rules and recent letters to Congress urging legislators to make price transparency a focus in the next Covid-19 stimulus. I’m pleased to see momentum around the topic, and I believe it’s critical to address price transparency and encourage healthcare shopping, especially as consumer expectations increase and they look for more ways to save money.

What it Means for Consumers
The old adage that “higher price doesn’t mean higher quality” is true in many ways, and especially in healthcare. Most consumers are not aware that price can vary significantly for the same quality procedure in the same geographic region. Ambulatory centers often offer similar quality procedures at dramatically lower prices, and prices for diagnostic imaging procedures, such as MRIs, are often dramatically less than going to a hospital. Price transparency, paired with complementary information such as patient reviews, provider quality and enhanced provider demographic information is critical to empowering consumers to understand and compare price differences in order to access the highest-value care for themselves and their families.

Healthcare is the only industry where consumers don’t consistently access information around cost of services and are unable to shop as they do for other goods and services in their life, but it’s one of the most important areas they should be shopping for to receive high-quality care at the best price. Consumers want to shop for their healthcare, but the issue is they don’t know where to go to do so. As consumers begin to reschedule appointments and procedures delayed by Covid-19, being able to compare costs and shop for healthcare is an important component, particularly during difficult financial times.

Increasing Awareness of Shopping Resources
According to Health Affairs, only three percent of Americans compared costs across providers before receiving care in 2017. This is likely due in part to limited awareness of pricing information available to consumers and difficulty in accessing this information. However, innovative tools offered through health plans can improve price transparency and help consumers better shop for their care, understand price options and enable them to make more informed care decisions, and even in certain cases, get rewarded financially for choosing high-value care.

Consumers should easily be able to see before making an appointment if a provider is in-network, understand their total costs and how much they will need to pay out of pocket. Without this information, costs can add up and negatively impact their wallets, especially as insurance costs are expected to increase due to Covid-19, according to a recent analysis. As an industry, we must be more mindful of these situations and take steps to solve them. We need to be more proactive in communicating to consumers where they can go to get information they need to make informed decisions on the right care at the right time and at the right place.

Leveraging healthcare cost-savings solutions, powered by provider-specific, cost and quality data makes it easy for consumers to find the right care at the right price. Consumers are open to using these tools too – more than 8 in 10 adults say they would find both an online healthcare navigation tool and live personalized customer support to help compare costs and schedule appointments to be helpful. Additionally, financial rewards have been proven to be catalysts to drive shopping and guide consumers to high-value care.

The Importance of a Human Touch
Healthcare choices are among the most significant decisions consumers make, and many people want to speak to a healthcare advocate to help them evaluate options, schedule appointments and navigate their care journey. Pairing a human touch with online price transparency tools provides increased consumer confidence and a seamless, personalized experience. Furthermore, giving patients the option to shop online, or directly with customer assistance teams via talk, text and chat, increases engagement and makes the shopping process convenient.

Given the national and state conversations around healthcare price transparency, I anticipate seeing increased awareness of quality cost-saving solutions this year. What it will come down to is which tools can break through the noisy transparency market and actually help consumers understand their care options in a better, more meaningful way. By providing actionable and personalized information, healthcare technology companies can enable consumers to make confident healthcare choices and drive down healthcare costs.

Photo: atibodyphoto, Getty Images

 

 


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Kyle Raffaniello

Kyle Raffaniello is the CEO of Sapphire Digital and a proven leader in the health care industry with over 25 years of experience in accelerating corporate growth. She has a passion for excellence in bringing innovative solutions to market that add value to clients’ operations.

Previously, Kyle was Chief Strategy Officer and Executive Vice President of ValueOptions, a behavioral health company, where she was responsible for profits across all lines of business. She was Senior Vice President, Sales and Marketing for Consortium Health Plans, an organization focused on account growth and retention for the nation’s 20 largest Blue Cross Blue Shield plans. Kyle has also held senior sales and marketing positions at a number of regional health plans, as well as led provider relations for several large medical delivery systems.

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