Increasing usage of tools
To get more members to use these tools, plans need to include more information in them, both in terms of expanding the conditions listed and also the price range data from individual providers.
“It will require cooperation from providers; the ability to reveal prices to members may need to be written in some contracts with providers,” Shehata says. “Plan design and the increased cost shifting to members is going to make these tools a necessity, so links may need to be more prominently featured online and not only on regular web browsers but also optimized for mobile phones and tablets. Health plans should encourage members with chronic illnesses to use these tools because they are the ones generating most of the costs. Health plans will need to use simple language to help engage members to determine the cost of procedures, describe what their benefits will cover, and find out which providers offer the best treatment.”
Mobley believes health plans should promote tools through digital advertising forums which will allow consumers to see them in places where they are already going for news and information, including social media platforms such as Twitter and Facebook. “Plans should also consider offering a financial incentive to members who use a transparency tool to choose a provider and then schedule and attend an appointment with that provider,” she says. “This incentive could be as simple as a $5 Starbucks gift card.”
Plans can increase customers’ use of these tools by expanding them from digital-only to multi-modal channels such as mobile, text, and audio/visual, and as a result, increase the potential savings, Meier says. Additionally, transparency tools combined with benefit designs such as reference-based pricing (i.e., paying up to a fixed amount for certain non-emergency services you can shop for) or incentives such as member rewards (i.e., a cash reward for visiting a lower-cost location) can motivate members to act on the information provided by the transparency solutions and ultimately select higher-value providers.
What the future holds
As members continue to see increased out-of-pocket costs and programs that offer financial incentives for selecting quality and lower-cost providers, Meier expects to see increased use of transparency tools across multiple channels (i.e., digital, mobile, text, and telephonic). In addition, he expects underlying transparency information to be embedded into other aspects of healthcare, such as benefit designs, incentives, and networks.
Finally, the future of cost transparency tools will undoubtedly be impacted by the shift from fee-for-service reimbursement to value-based care arrangements. “As financing arrangements shift more risk to providers, we expect providers to increase the use of transparency information given new financial incentives,” Meier says.
Consumerism continues to increase in healthcare, and consumers are thirsty for cost and quality transparency tools that will help them navigate these waters, Mobley concludes. Tools that successfully enable patients to find the highest value care—the right care at the right price—will see their usage grow.
Karen Appold is a medical writer in Lehigh Valley, Pennsylvania.