The final piece to controlling costs in a High Deductible Health Plan World

More and more employers are offering High Deductible Health Plans (HDHP) and the trend for total replacement continues to gain momentum as employers look to control costs and stay under the Cadillac tax that becomes effective in 2018. As insurance brokers, we have recommended HDHP plans or over 5 years and many employer clients have embraced the strategy with wellness incentives, telemedicine options, contributions towards Health Savings Accounts (HSAs), and lots of education.

The final piece to controlling costs in a High Deductible Health Plan World How do you expect a healthcare consumer to shop for healthcare the same way they shop for a new refrigerator? Not an easy task. Things are beginning to change. Anthem Blue Cross in 2015 started building pricing comparisons on their website. You can now check the price of an MRI or other similar services based upon your location and the results are quite surprising. Consumers are now more educated and the physicians across the state started to review the disparities in pricing.

In January, Blue Cross and Blue Shield of North Carolina unexpectedly launched an online site that allows the general public to see how much it pays particular providers for certain services. The insurer’s move was spurred in part by a state price transparency law.

BCBS of North Carolina assembled the guts of its online price transparency tool in 2012, said Dr. Brian Caveney, the insurer’s medical director. Members were able to log on, find providers and see a detailed estimate of how much they would owe out of pocket for particular services.

Last year, Priority Health, the health insurance arm of Spectrum Health in Grand Rapids, Mich., launched a price transparency tool for its members. The tool shows them the average market rates for area providers for 300 procedures and how the costs will affect their out-of-pocket payments. In July, Priority Health started a rewards program to steer members to lower-cost providers and settings. They can earn a Visa gift card worth up to $200 if they select a provider offering a below-average market price. “We really want engaged members,” said Joan Budden, chief marketing officer at Priority Health.

The new wave of transparency is the final piece in controlling healthcare costs. If you expect the consumer to price shop, they must be armed with the data needed in becoming conscientious consumers of healthcare.

Burman S. Clark

Burman S. Clark, RHU, CSA is the President of Muneris Benefits and a licensed insurance broker and consultant. His independent practice and focuses on employee benefits, individual life, disability, medical, and senior products. Burman has traveled extensively and provided guidance to large employer associations with regards to the Affordable Care Act.