Study of Anthem Blue Cross members reveals price transparency tool alone doesn’t lower costs
This month Health Affairs published a study finding a price transparency tool did not reduce overall spending among the beneficiaries of the self-insured California Public Employees’ Retirement System. In their abstract, authors Sunita Desai, et al, report:
“Overall, offering the tool was not associated with lower shoppable services spending. Only 12 percent of employees who were offered the tool used it in the first fifteen months after it was introduced, and use of the tool was not associated with lower prices for lab tests or office visits. The average price paid for imaging services preceded by a price search was 14 percent lower than that paid for imaging services not preceded by a price search. However, only 1 percent of those who received advanced imaging conducted a price search. Simply offering a price transparency tool is not sufficient to meaningfully decrease health care prices or spending.”
This doesn’t surprise us. Pricing transparency tools alone don’t lower costs. Individual modules, such as price estimators, schedulers or telemedicine applications do very little to help consumers. The price transparency solution used in this study, as well as other solutions on the market, provide estimated prices and don’t tell patients what their out-of-pocket expenses will be. No one buys anything based on estimated prices. If you don’t know what’s going to hit your wallet, then it’s a moot point. It doesn’t mean anything. In addition, these applications don’t allow users to book appointments or pay for services. They don’t provide the same experience as shopping online. This is how healthcare continues to operate and why the financial state is dire and is expected to get worse.
According to the National Business Group on Health’s Large Employers’ 2018 Health Care Strategy and Plan Design Survey, “employers project the total cost of providing medical and pharmacy benefits to rise 5% for the fifth consecutive year in 2018.” As a result, the survey reveals that “Virtually all employers (96%) will make telehealth services available in states where it is allowed next year. More than half (56%) plan to offer telehealth for behavioral health services, more than double the percentage this year. Telehealth utilization is on the rise, with nearly 20% of employers experiencing employee utilization rates of 8% or higher.”
Large employers are going to need a lot more than price transparency tools to drive their employees to telehealth and other cost-saving services and providers. What will lower costs is a medical e-commerce experience that allows their employees to shop online for services or procedures, much like they’d use Amazon.com to shop for retail products. Because then employees have control over how they spend their money. When people have choices, the savings will follow.
Ever notice when you shop for products on Amazon you’re given comparison products along with prices? That’s what consumers and employees expect: the ability to comparison shop for healthcare services and procedures. Then, when someone has a sore throat, she can decide if the telehealth choice is better than driving to her doctor’s office. Or, she can see at a glance that the emergency room visit for a sore throat will cost several hundred dollars, where a visit to a retail clinic will cost only $50 to $75. If we are giving people a true e-commerce experience, not only do they see comparisons, they also have options to schedule and pay for their services right at the time they make their selections. And it needs to be a simple experience for the consumer. Extremely simple.
Sounds ideal, right? A simple-to-use, yet complete e-commerce medical marketplace to help corporate America’s businesses and employees save money on healthcare. The ideal solution is a platform that gives consumers the ability to comparison shop with lists of actual out-of-pocket expenses, select the highest quality services for the lowest price possible, and to finish the transaction while they are in the application, unlike the solutions that only offer estimates or appointments.
The best part? The ideal solution exists and is ready to be implemented. HealthQRS has created an e-commerce medical marketplace that can actually lower costs. Even though it’s complicated beneath the surface, it’s extremely easy for the consumer to use. Think of it like a Priceline or Expedia for healthcare, where a user simply types in the procedure or service he or she needs, and a list appears on the screen complete with exact out-of-pocket costs. Our built-in navigation can direct consumers to telehealth services as well. In addition, our software is enabled for voice recognition.
HealthQRS has the solution for a complete e-commerce medical marketplace
HealthQRS has created an e-commerce medical marketplace that allows consumers to shop, schedule and pay for procedures and services from their smartphones, tablets or computers. When consumers use our platform, they can instantly access their network, see a list of procedures and providers in order of least to most expensive, select a location, schedule the appointment, access their HSA or FSA and pay for it all from the app. (Our system can also manage health reimbursement arrangements.) Consumers see their exact out-of-pocket, not just estimates. Our powerful algorithms calculate the exact, true amount, not just estimates that they will owe. HealthQRS’ unprecedented, cutting edge technology combines metrics from provider contract rates with payers, insurance verification, patient financial responsibility, payer claims adjudication logic, and in a millisecond, calculates the patient’s exact out-of-pocket expense. No one else is doing this.
What really makes HealthQRS stand out from everyone else is our platform. We have put together over 30 modules all working together to provide a holistic, seamless, total experience for the consumer from start to finish. We combine navigation, the capability to make an appointment, referral management (if needed), payment management and so much more than we can list here. Developing a solution of this magnitude didn’t happen overnight. We started with the consumer experience in mind and spent years drawing on the knowledge of best-of-breed experts to perfect, fine tune and put together this complicated, yet complete and easy-to-use solution for medical e-commerce.
HealthQRS has perfected the platform to provide an e-commerce medical marketplace and we are here to help employers of all sizes. We have over 12 years of experience developing healthcare retail experiences for consumers and our founders have over 50 combined years of e-commerce experience. We can have providers, payers or facilities set up in a matter of weeks at the point-of-service and online. And because we are a software as a service (SaaS), our customers don’t incur any capital expenses, only a low monthly fee. We invite you to learn more about HealthQRS and our e-commerce medical marketplace. Why not contact us right now for more information or click here to schedule a demo? Or click here for a quick, 6-minute video about our e-commerce strategy
 Sunita Desai, et al, “Offering A Price Transparency Tool Did Not Reduce Overall Spending Among California Public Employees And Retirees,” Health Affairs, Aug. 2017, http://content.healthaffairs.org/content/36/8/1401.abstract?sid=ff718c01-835b-494a-a821-dde8c29c42b2
 “Large U.S. Employers Project Health Care Benefit Costs to Surpass $14,000 per Employee in 2018, National Business Group on Health Survey Finds,”, National Business Group on Health Press Release, Aug. 8, 2017, https://www.businessgrouphealth.org/news/nbgh-news/press-releases/press-release-details/?ID=334