Benefit managers love the idea of transparency in healthcare programs — comparing the price of MRIs from one facility to the other, for example — but getting employees to use the data in their healthcare decisions remains a challenge.
“When you look at transparency, one of the keys is how do you get people to use it? As well as what is the data that is involved with it?” said Mary Catherine Person, president, HealthSCOPE Benefits.
“As you have clear information that is provided to people that is relevant — this has a big impact on folks. And continuing to keep information in front of people is key,” said Person.
Person was part of a panel at EBA’s recent Workplace Benefits Summit entitled, “The future of transparency — Separating fact from fear.” The panel was comprised of benefit professionals who use Healthcare Bluebook transparency solution — much like the Kelley Blue Book that automobile buyers use to rate the value of their car purchases.
“As an employer, the other piece is helping them to understand what some of those costs mean. That is one of the keys in the work we have done: being able to stratify by individual services and what things cost such as helping people understand the variants in the MRI down to the individual provider,” said Person.
She added, “As the tools have been developed and you can get them down to the aspects of care that are very specific to the individual patient, it is more meaningful for people.”
So far, healthcare transparency is paying off for Nashville Electric Service, the power company that powers the city of Nashville and its surrounding neighborhoods. The power company started looking into healthcare transparency in 2014 and began using a solution last year.
“We have dipped our foot in waters at this point and we think there are much larger returns than is expected,” said Jeffrey Eck, compensation and benefits manager for Nashville Electric Service. “We are on the cusp of something good here. It has come of age. It is measurable and it is something that can be a success.”
According to Eck, “If your healthcare costs are skyrocketing, it is a tool in your toolbox you can use. We want our employees to use the best tools and get the right care they need at the right time at the right price.”
For panelist Nancy Reardon, chief product officer for Maestro Health, transparency’s “goal is to make people benefits friendly again.”
“To me, it is about creating habits and making sure these tools are available and that they are part of their lifestyle,” Reardon said.
She likens the transparency program to modern mobile telephones. “When we got a cell phone it was all about making phone calls. But someone said, what if we added a camera? And all of a sudden you are using a cell phone for taking pictures, sending texts, and now how many people can’t live without their cellphones?”
This is what benefit providers and insurance brokers must build into the healthcare markets, according to Reardon. “We need to create opportunity where we are engaging consumers to they have their personalized information available to them and get them to build that habit,” she said. “At Maestro, we are trying to build those interaction points.”
“Our motto is, ‘Data is data,’ but if you can turn that data into actionable information — where someone actually does something with it — then this is the Holy Grail,” said Reardon.
The harsh transparent truth
Sometimes, benefit administrators are shocked at the differences that the data reveals. “When you look at transparency tools, there is a wide swath of tools that use different version of the data. Some are using state data, Medicare data, commercial data augmented by the others guys,” said Person. “One of the things we discovered was some firms saw variations in their data in pricing in the same network based on the type of network they were using.”
When you show the data to employers, they are sort of shocked that the facility they thought was the low-cost leader and that they told the employers had a much lower discount, and then they see the variation in how they stacked up for the exact same service at another facility,” said Person.
And this includes variation of facilities in the same network. “We have also seen a facility that is owned by a sister facility and when you stack them up, you see dramatic differences in facilities that are less than 20 miles apart. And those facilities may have the exact same corporate name on them, but that name has very little to do with what the charges are or what the reimbursement rates are,” said Person.
And transparency is not just about cost, according to Reardon. “Quality is important, too. You can’t just zero in on the price,” she said.
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