Last week, HealthSparq brought together an expert panel discussion featuring two health plan executives, a regulatory pro, and HealthSparq’s SVP of Product to dive into current price transparency mandates and the opportunities that health plans have to go beyond the letter of law to meet the goal of helping people make smarter healthcare choices. Below are some of the key takeaways from the session that featured Shane Bray, Blue Cross Blue Shield of Louisiana’s Chief Customer Experience Officer, Sydney Edwards, Kyruus’ VP Regulatory, Mike Gordon, Friday Health Plans’ Chief Innovation Officer, and HealthSparq’s Matt Parker.
Transform relationships with members by building a foundation of trust
According to Edelman, only 43% of people in the US trust their insurance (11 point decline since 2019), while at the same time their expectation for transparency solutions and navigation continue to grow.
As our panelists highlighted, consumer demand for transparency is what has got us to this point, but healthcare is hard and transparency is complex. There is a significant opportunity for health plans to leverage these consumer demands to help build higher levels of trust by providing easy-to-understand, helpful, and accurate information. Health plans are in a unique position to deliver the information people want and need, and people are looking to their health plans for help.
People need guidance and clarity, along with information about their expected costs, to see a path forward in their time of need for healthcare. While the mandate requires specific data elements and information in terms of messages, it doesn’t require presenting cost data in context to a member, specific billing practices, or make things easier for people to understand. That’s where plans can leverage their expertise and build trust.
Deliver on the Experience
“Even if we have the best tools in the world, if they aren’t intuitive and they are contextual, they won’t be used. It has to be contextual to the member’s experience,” said Bray during the session. “Healthcare is not like buying a pair of shoes,” he continued. “Variables in healthcare are a lot more complicated, and adding complexity to complexity doesn’t make it easier.”
Gordon offered that: “Members are different, they have different preferences. The goal should be to offer members all the different ways that they may prefer to interact with you as a health plan and make that available to them.” He mentioned that mobile will be increasingly important, and not just apps. His health plan will also be leveraging SMS, what he called a “simple and convenient way to engage with members, particularly younger members.” He also commented that this is why consumer experience positions are being added to health plans today from different industries, to infuse a different way of thinking into the business.
Partner with Providers
Bray put it best on the topic of partnering with providers: “Partnership with providers and exchange of data is an integral part of the process.”
Edwards added that providers have to meet mandates as well through the Price Transparency Rule for Hospitals. She recommended that the trust patients have with physicians will be key in building the optimal state of transparency. Partnering with providers to ensure consistency in information and to serve a channel for member communication are additional considerations for health plans. Increasing engagement is a win-win for both payers and providers. At the end of the day, accuracy and consistency will be themes that transfer over for both payers and providers on the mandates
Recommendations for Health Plans
Edwards left attendees with three calls to action:
- Update claims data as much as possible, that is a key element for working around and with the mandates
- Have a view of compliance outside just the mandates, think of the market opportunity and what can be done to differentiate from other plans. How are you communicating that to your members?
- Take member feedback!
Gordon left us with this note, “Start now…It’s much more complicated than implementing a new software application into your tech stack. The data is always the long pole in the tent and I’d suggest thinking more broadly. How can you make the best data available that has the most likelihood of ultimately producing an accurate price estimate when it comes out the other end of the tunnel? If you don’t start early, you’ll lose options of things that you may want to include that could result in a better experience due to the time pressure.”
Bray added a closing thought: “I think the spirit of the law is what we are after here. Maybe it’s not the letter of the law, the idea is to improve the healthcare experience in digital and modern ways. Come to a common ground, continue to innovate, and change the landscape of healthcare for the positive.”
HealthSparq has 10 years of experience delivering compliant transparency solutions to payers for their members. Even more than checking the box on compliance for our clients, we put people at the center of everything we create, developing intuitive and engaging user experiences that help achieve our mission of helping people make smarter healthcare choices. If you have any questions, just reach out to us, we’d be happy to chat.
