Consumers want more transparency, trust with health care providers
A lack of pricing data was a common theme that diminished trust with providers.
A lack of transparency coupled with a general distrust of medical providers are among several factors that are frustrating businesses and individuals purchasing coverage, according to a new report.
The Council of Accountable Physician Practices and National Alliance of Healthcare Purchaser Coalitions conducted listening sessions in 2019 and 2020 with the goal of helping the health care industry better understand what purchases need and how they evaluate services.
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A common theme raised throughout the sessions was pricing and transparency, according to the groups’ report.
“What I show my executive team every year is that the health of our population is declining and at the same time our costs are going up at twice the rate,” one employer told National Alliance. “So, they’re trying to figure out what it is we’re getting; what are we buying? The outcomes are terrible.”
The report notes that the average out-of-pocket costs for an enrollee with employer coverage grew 58% between 2007 and 2017, according to data from the Peterson-KFF Health System Tracker. That is more than double the increase in average wages during the same period.
Some employers called for up-front estimates for out-of-pocket expenses as one way to mitigate the impact of expenses and surprise billing.
Another concern fueled by the lack of pricing transparency is overtreatment from providers who recommend unnecessary services to drive up profits.
“Where are our dollars going?” another employer told National Alliance. “Right now, we really feel like we don’t have much control over how we are spending them.”
A lack of metrics to evaluate providers was another stumbling block. Several employers said clinicians should follow best practices and evidence-based medicine, but they doubt those standards are consistently met.
Overall, the listening sessions found employers generally distrust their health care providers, which poses a barrier to developing closer relationships between the two sides and improving the current system.
“No one is ever going to listen to insurance companies,” one employer said. “But physicians and employers could say, out loud, ‘This needs to get better. We’re part of a system that’s broken, we’re going to explore some fundamental change.’ . . . But if no one’s willing to say, ‘I’m open to change,’ then we’re never going to change [the system]. If someone [providers] could just raise their hand, and say, ‘Hey, I’m part of the problem, but I’d like to fix it,’ that might loosen it up a bit.”
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