What challenges does the healthcare industry face with price transparency?

Leaders from across the healthcare industry share insights about price transparency, Part 1 of 3

Introduction: Since the White House released an executive order to help improve price transparency for healthcare consumers, industry leaders have been discussing and preparing for the final rule. This post is the first in a three-part series sharing insights from an executive panel that included Millicent Cox-Edwards, Senior Director, Kaiser-Permanente; Sander Domaszewicz, Principal and Senior Consultant, Mercer; Dr. Jeffrey Guy, Vice President, Clinical Services Group, HCA Healthcare; and Lilly Stairs, Patient Advocate and Head of Client Relations, Savvy Cooperative. Statements have been edited for clarity and length.

There is a renewed energy around quality and price transparency as a national dialog emerges around mandates. Providers, health plans and employers are evaluating their plans and preparing to deliver more price information to healthcare consumers and help address the challenges ahead. During our webinar we asked:

It’s not just about the prices; consumers require support

Millicent Cox-Edwards (Health Plan/Provider): As both a health plan and provider, we have a unique perspective and commitment. Patients should understand quality and cost before receiving services, and we’ve started to move to an automated model to send price estimates proactively prior to the day of service…But the industry needs to resist the temptation to take consumerism in healthcare and compare it with other goods and services that are discretionary. Healthcare is more expensive, confusing and emotional. We need to empower members with information and support, and we haven’t done our part if we just put our prices in the window.

Pairing high-tech with high-touch will deliver more value

Sander Domaszewicz (Employer): Many employers are trying to get at how they can provide value to their employees and families. Most have cost and quality tools, either their own or through their health plan, but adoption is low and barely over a quarter of them believe their quality initiatives have been effective. There just hasn’t been a success in patients feeling like they’re better prepared, more involved or more informed. There is a movement away from offering a self-service tool and changing the dynamic around when and how transparency information is delivered. Pairing high-tech with high-touch helps patients better understand the consequences of not getting care.

More education, financial resource support will be critical

Lilly Stairs (Patient Advocate): We haven’t reached a point where we’ve seen high levels of transparency, so there is still a lot of confusion. Educating patients and pointing them in the direction of financial support will be very important. When we open up the flood gates of information and share exactly what it’s going to cost to go in for that appointment, patients will need support to make the best decisions for their health. Especially if the information is auto-generated, it’s important to get on the phone and have conversations. Those high-touch interactions with patients, speaking their language and offering potential financial resources to help them get the care they need, will help towards achieving positive outcomes.

Don’t overlook patient-provider relationships and quality

Dr. Jeffrey Guy (Provider): Price transparency and quality should go hand in hand. A woman with a history of breast cancer and risk factors, for example, shouldn’t get a mammogram with the best price of the moment and risk losing the longitudinal quality of care with her radiologist and oncologist. There are a lot of unintended consequences like that, that physicians worry about…healthcare is not a commodity. Quality matters, people matter. Price is an issue and it needs to move forward, but it’s important not to overreach; it’s not all about the price. Be mindful that relationships between patients and providers make a difference.

Listen to the full webinar

 

Read other posts in this series:

What are the potential unintended consequences of price transparency the industry should avoid?

What technologies are needed for success with price transparency?

MOST POPULAR