BRENTWOOD, TN – More than 60 percent of self-insured employers in the United States are expected to offer a consumer-driven healthcare plan this year. Many of them – and their employees – will need to know how to “shop” for healthcare services.
That’s where change:healthcare comes in. The Brentwood, Tenn.-based company has created a Cost Transparency Solution that draws from more than 2 million medical claims to provide information on healthcare costs and services.
Christopher Parks, the company’s founder and CEO, said today’s patients need to make decisions about their healthcare and have plenty of data, but that data isn’t put into context. The company’s Cost Transparency Solution “offers all the things that Amazon has figured out,” he said, by giving both the consumer and the employer information on available healthcare sources and rates.
Parks said he first focused on consumer-facing data, but quickly realized the indices would be most effective if populated with real claims data. By aligning with health plans and self-insured employers, he said, the indices serve both employees and employers who manage their own health insurance plans.
“Cost transparency is going to be a critical piece of the puzzle as we move toward an (accountable care organization) model, where all parties – from patient to hospitals to physicians to payers – are much more holistically involved in care,” he added.
The company has also started publishing a Healthcare Transparency Index, a “quarterly benchmark” that’s designed to highlight ongoing trends data about healthcare costs. The latest index (the company has released two) was published in March, and focuses on key drivers of cost variances for routine medical services. They include: age; retail or kiosk options; location; and specialty office appointments.
Parks said the index, as well as the Cost Transparency Solution, could also be used by providers, “who can be just as blind as the consumer.”
“They need to figure out how to develop ACOs,” he said. “For instance, there’s no point in prescribing a medication if someone can’t afford it.”
Among the companies using change:healthcare’s Cost Transparency Solution is the PRISM Services Group, a Lewiston, Texas-based healthcare software and services company which made solution available on its CLARUS Search Platform in April. PRISM officials say their health plan clients serve more than one third of the nation’s insured population, and the CLARUS platform sees more than 4 million visits per month.
“In augmenting our platform with a healthcare cost module, we looked for a solution that offered an extensive breadth and depth of pricing information, a user-friendly experience for the consumer and a simple and fast implementation across out client base,” said PRISM CEO Ray Larson.
Parks said he isn’t trying to highlight the cheapest provider nor rate which ones are better. “I’m trying to shift, to bend the curve” toward the consumer, he said.
“Several studies have documented cost differences among major, big-ticket medical procedures and surgeries, but we still lack basic information about variability in everyday, routine medical visits that add up over time – not only for patients, but for the nation,” said Wendy Lynch, an industry researcher and author of Who Survives? How Healthcare Costs are Killing Your Company, in a press release supplied by change:healthcare. “As more and more consumers pay directly for their own healthcare, the need for this kind of healthcare cost transparency becomes even more essential.”
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