In recent years, there has been an incredible transformation in the healthcare industry, especially in the role of consumers. A decade ago, health plans worked with employers to manage almost all health benefit decisions, leaving consumers relatively unaware of the costs associated with their healthcare needs. Not so today.
Today, employers and consumers are more frequently choosing plans with higher deductibles; more than 15.5 million Americans are enrolled in such plans, according to America's Health Insurance Plans. That has encouraged consumers to become more sensitive to their healthcare costs, as they now have a greater, more direct financial obligation for their care.
This rise of consumerism in healthcare has presented unique opportunities and challenges for health plans. As a result, more effectively engaging with consumers has become a high priority for health plans to remain competitive and maintain customer satisfaction.
To meet these new challenges, UnitedHealthcare has focused on three key aspects of healthcare consumerism: education, administrative and financial. We have made significant progress in the education and administrative aspects, especially through new programs, websites and even gaming. To improve the financial side, we had to think beyond traditional industry standards, collaborating with healthcare providers and new partners to improve how consumers manage and pay their medical bills.
EDUCATION
To provide additional information for consumers, we created an array of educational materials and resources to help consumers make more informed decisions around when and where to access care.
One example is the UnitedHealth Premium designation program, which recognizes physicians who meet quality of care and cost efficiency criteria. The program uses national industry, evidence-based and medical specialty society standards to evaluate physicians across 25 specialties, including family practice, internal medicine, pediatrics and cardiology. This information is provided to consumers to help enhance the health care decision-making process, improve the experience and reduce costs.
We also took steps with care providers to better engage consumers, including the creation of patient-centered medical home programs and the use of care provider contracts that link reimbursement to quality and efficiency measures. These efforts put the patient at the center of the health care experience, providing resources and support to help prevent disease and better manage chronic conditions. Already more than $30 billion of our reimbursements to hospitals, physicians and ancillary care providers are paid through contracts that link a portion of the reimbursement to quality and cost efficiency. That number will increase to $65 billion by 2018 as more care providers join the transition to accountable care contracts that reward quality and value-based health care.
ADMINISTRATIVE
Our company's member portal, myuhc.com, helps meet consumers' administrative needs by providing access to personally relevant plan, benefit and network information. We also offer information to help our health plan participants understand how their benefits were applied to their claims with simple, consumer-friendly explanations of health care and insurance terms. We are even using game play and game mechanics to help consumers better understand and use their health benefits.
In addition, we created a mobile application called Health4Me, which puts crucial health and plan information, and decision support, at consumers' fingertips. The application also includes myHealthcare Cost Estimator, a service that enables consumers to comparison shop for health care services based on quality and cost. Since the introduction of myHealthcare Cost Estimator in 2012, consumers have generated more than $1.7 billion in estimates, while also more frequently selecting high-quality providers.
We are also collaborating with other insurers and the Health Care Cost Institute (HCCI) to develop an online tool that will provide consumers with transparent and comprehensive information about the price and quality of health care services. The information will be available not only to consumers, but purchasers, regulators and payers as well in an accessible, comparable and easy-to-use format.
FINANCIAL
Improving resources that help consumers understand their health benefits was a crucial step, especially to help address questions about claims, explanation of benefits (EOBs), deductibles and more. Although consumers could view benefit and claim information through our member portal and mobile app, we realized people wanted an easier way to understand, manage and pay their health care bills in one convenient online location.
One solution was to email consumers when they had a new claim, with a link to our member portal. Once there, consumers can clearly identify the claim and their financial obligations, as well as pay their medical bills with their credit card, debit card, health savings account (HSA) or bank account. This service adds convenience for consumers while helping health care providers get paid more quickly. To create this functionality, we collaborated with InstaMed to process the payments and meet the necessary compliance, regulatory and technological requirements. So far, the service has processed more than 326,000 member payments to about 50,000 health care providers, totaling more than $35 million.
Tom Paul is the chief consumer officer of UnitedHealthcare.