How Price Transparency Can Bring Efficiency Into Healthcare, per Matt Parker of Kyruus and HealthSparq

MHE spoke with Matt Parker, vice president of Products at Kyruus and HealthSparq, about the recent price transparency rules that recently went into effect and how they can bring efficiency into care.

Below is a brief excerpt of the conversation with Parker, which has been edited for length and clarity.


Q: Price transparency is supposed to work to bring some efficiency into healthcare. The idea is if people can see prices, they will shop for healthcare. But some experts say healthcare is fundamentally different and that kind of market discipline won't take place. What do you think?

A: I think my point of view is that price transparency is a part of the solution. It's not the only part of the solution, though. Healthcare is different than other consumer behaviors, right? You don't buy healthcare because you want to buy healthcare, because you need to.

You can be placed in a situation where you don't even know that you have a choice in how you engage with services. But what we see as an evolution: payers have engaged with their members over the last 10 years or so around transparency and are finding ways to engage with their members. In new and interesting ways people are starting to ask for and think about this information.

So I would agree with folks that would say price transparency isn't a silver bullet. It isn't. But it's definitely a key and important component to having people make decisions about healthcare that are cognizant of cost and quality, right? Without the information it's hard to blame people for not seeking out prices when they don't have it available to them to from their payers.

Related: Price Transparency and Insurers' Compliance to These Rules

We see this as sort of a necessary step to begin that evolution of people thinking about, "what are the implications from a financial perspective, from a network coverage perspective, from a quality of care perspective?"

Q: With price transparency and price transparency regulation, what lessons did your organization learn that might apply to price transparency regulations going into effect today?

A: I think the key for us is all regulations around transparency are really meant to support individuals who are engaging in sort of economic behavior that can have important financial ramifications for them.

Releasing data, which is what today is about, really is a part of that. But it can't be the only part it needs to be.

We see it sort of as the baseline to help somebody use this information to make a healthcare decision. You need the information. But you've got to build the experience, you've got to build the engagement, you've got to build the toolkit for a person who's kind of not conversant in healthcare and doesn't understand how all this works.

You've got to build a place for this person to go and understand that context, in a way that meets people where they are usually when they're in pain, or scared or worried. It's one thing to sit down and do research on something that's complicated when you're at your best, but nobody buys healthcare when they're at their best. It's an important thing to layer on a set of tools and an experience, and that's what our organization has been doing for a long time: is really focusing on how to how to provide guidance to people who are making these complicated, financial decisions around their health and understand what their options are.