Why employee decision-making is only part of the health care cost problem
Giving employees transparency into rates is a good start, but three-quarters of health insurers already offer price transparency tools.
In late October, the Trump administration finalized new cost transparency rules for providers. These rules will require health care payers and self-insured plans to provide clear information on cost-sharing and to “publicly disclose the rates they pay to providers through online tools,” giving about 200 million Americans “access to real-time price information.”
This information could help Americans know how much their health care will cost them before going in for treatment. Insurers must provide negotiated rates and personalized estimates for 500 services and items by Jan. 1, 2023, and must make rates for all items and services public by Jan. 1, 2024.
Starting with price transparency
Price transparency for health care consumers is important, but it’s only part of the solution. The recently finalized rules from the Departments of Health and Human Services (HHS), Treasury, and Labor aim to make cost-sharing estimates available to individuals before they receive care — to encourage comparison shopping and protect consumers.
These are just some ways the new rules will promote price transparency, according to the CMS website:
- Require hospitals to post their standard pricing information
- Require hospitals to make prices more transparent beginning in 2021
- Allow consumers to compare Medicare payments and co-payments for certain procedures
- Launch Care Compare, which includes visit cost estimate information for new and returning Medicare patients
- Make quality information available for the first time on all exchange plans
- Require hospitals and clinicians to be subject to potential payment reductions if they do not give patients access to their data
- Launch the Provider Data Catalog (PDC), which provides downloadable and interactive datasets
Driving smarter decision-making
Giving employees transparency into rates is a good start, but three-quarters of commercial health insurance providers already offer price transparency tools. So for some health care users, price transparency may not be new or particularly game-changing. If employers truly want to cut health care costs for employees and the business, they must drive smarter decision-making throughout the organization — starting at the very top.
The right health benefits analytics solution helps employers put their health data to work. With these insights, they can gain control of their company’s health spend, design better strategies and plans, and work toward preventing disease with data. Having a platform like this will help you attract and retain top talent while identifying unexpected cost sources and forecasting the impact of those costs on your business.
What’s better, reactive or proactive?
What’s more valuable? Knowing how much a procedure costs or taking proactive steps to eliminate health risks and possibly help an employee avoid a costly procedure altogether? Not to mention being able to recommend lower-cost drugs, mitigate risks, close care gaps, and improve the efficiency of care. The right health care analytics solution can help you do all of that.
You need technology that doesn’t just give you data — we all have plenty of that — but also gives you direction. You need to know what all that information means for your employees and your organization and how to move forward.
Using tech to uncover opportunities
The right technology can help you take a more proactive approach to employee health. Access to predictive insights and actionable recommendations can drive immediate impact by identifying patterns among your employee population, uncovering opportunities to avoid unnecessary procedures, and targeting at-risk populations.
Now more than ever, employees are looking to their employers for support and guidance with regard to health care resources and benefits. By using a health intelligence solution that puts your employee health data into action, you can identify the right benefits programs that let your people know they’re not on their own when it comes to getting the right care for the best price — or improving their health and avoiding treatments and procedures altogether.
With a platform that gives your organization forecasts and actionable insights, you can make decisions with confidence and design plans that help your employees get the care they need for the right price. Giving employees transparency is a great first step in helping them reduce health care costs. However, there’s an even greater opportunity for employers to take significant steps toward more affordable, effective health care.
By bringing their data together and getting a deep understanding of employee health and care utilization, employers can make more informed decisions that sharpen plans and programs to drive improved health, higher savings, more engaging experiences, and a stronger business.
Joy Powell brings over 25 years of executive leadership experience spanning various industries, including insurance, health and wellness, and health analytics. Before joining Springbuk, she served at Healthways as President and Chief Operating Officer. Joy later transitioned to CareSync, filling the familiar role of President and Chief Operating Officer. In early 2019, she brought her advising and solutions expertise to Springbuk as the Chief Operating Officer. In her current role as the President at Springbuk, Joy helps align and bolster day-to-day company operations and growth.
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