Employees continue to take on increasing responsibility for making key decisions about their health, including managing costs. Surveys from Aon Hewitt and the Kaiser Family Foundation indicate that the adoption of consumer-driven, high deductible health plans continues to grow, meaning more and more employees will find themselves charged with balancing costs and care.
In order for employees to make cost-effective, high-value decisions about their health and well-being, it is critical that they have access to information and resources featuring both cost and quality information so they can shop around to identify the best option for them.
When effective, these pricing transparency tools offers a number of benefits for both employers and individuals. By helping people make more informed decisions about their care, it reduces overall healthcare costs and cuts waste while connecting patients with quality care. However, despite the availability of these tools, utilization is lacking.
A recent study published in the Journal of the American Medical Association found that only about 10 percent of employees with access to transparency tools had used them. Another survey from the Kaiser Family Foundation indicated that less than nine percent of people had used price information when making a healthcare decision.
While consumers have access to pricing transparency tools, very few are actually using them to shop around and make cost-effective decisions about their healthcare, likely due to lack of awareness and education. According to a 2016 study from America's Health Insurance Plans (AHIP), 58 percent of health plans report that members are unaware they have access to these resources.
Further, even if they know about the tools, many people may underestimate the need or how they can help. Research from Public Agenda found that 57 percent of insured Americans do not think there is a cost difference among in-network doctors for the same services, which is not the current reality.
There are a number of steps organizations can take to encourage employees to take advantage of these tools and realize the potential benefits of shopping around for healthcare - improved outcomes and reduced costs.
Educate, Educate, Educate.
Comprehensive communication efforts can dispel any misconceptions about the need for pricing transparency and promote this service as the place to go for healthcare help. A 2014 Cicero Group survey of consumers found that 49 percent say better communication would drive usage of these tools.
Further, making it easy to find can have an impact - integrating it into the employee portal can improve both awareness and accessibility.
Incentives have been shown to drive engagement in wellness, and they can be an effective means to do the same for pricing transparency. According to the same consumer survey, more than 40 percent of respondents said reductions in their premium costs would encourage utilization of pricing transparency tools.
Provide Multiple Platforms.
Today's workforce spans multiple generations, so a one-size-fits-all tool will not work for everyone. While an app or website tool is a necessary component, offering telephonic support can make a big difference and help employees take the next step to access care.
Display Cost and Quality Side by Side.
Cost alone does not tell the whole story. In the absence of credible information about quality presented simultaneously with cost details, many patients may assume higher prices mean higher value, which is not always the case.
Make Tool User-Friendly.
The Cicero Group survey found that 33 percent of consumers thought pricing transparency tools were complicated. Consumers are more likely to use a tool that is intuitive and easy to use.
Incorporate Personalized Information.
In order for users to make the most informed decision, tools should include company and employee-specific data to improve accuracy and relevancy. This includes breaking out the details of all related costs, including the full price of services as well as the consumer's out-of-pocket responsibility.
The most effective tools are engaging and provide users with more than they were looking for, such as connecting them with resources to help them take the next step after reviewing cost and quality information. Healthcare pricing transparency helps employees become better shoppers by making high-value, cost-effective decisions that can lower healthcare spending.
However, in order for it to be effective, employers, insurers, and others must take steps to motivate engagement and utilization. A standalone tool may not be enough to motivate employees to utilize the resource; however, when combined with these strategies, pricing transparency tools have the potential to engage employees and help them become smart healthcare shoppers.
About the Author
Marcia Otto is Vice President of Product Strategy at Health Advocate. She is a Silicon Valley software veteran whose expertise is in healthcare transparency strategy and solutions aimed at reducing healthcare costs for businesses and empowering their employees to become more engaged and effective in their healthcare.