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Communities: Health Decision Support Tools

First-of-its-kind Benchmark Study Reveals Opportunity for More Health Care Transparency Tools

By Scott Decker, President, Healthsparq

The more consumers are responsible for paying a higher percentage of their own medical costs, the greater their need to know ahead of time how much they’ll spend on a treatment and be able to compare treatment options. Health care transparency tools to help consumers shop for care are increasingly available on the market, yet health insurers are lagging on utilization of these tools, and consumers—along with their employers and the health plans themselves—are paying the price.

But health insurance executives are about to pick up the pace. A recent study by the Cicero Group, sponsored by HealthSparq, of 186 executives at 117 health insurance companies found:

  • Sixty-five percent expect the level of transparency within the health insurance industry to continue to increase.
  • Fifty-four percent expected insurance company budgets to increase to account for the financing needed to buy transparency tools.

This finding is echoed by a recent study by research and advisory firm Aite Group indicating that the health care transparency industry is expected to grow to $3 billion by 2016.

This investment comes none too soon. America’s Health Insurance Plans (AHIP) recently listed “Tackling Barriers to Transparency” as one of three key strategies for reducing health care costs. And in June, the American Medical Association called on insurers to provide physicians with better tools to automatically determine a patient's payment responsibility before treatment.

Increased health care transparency is woven into most discussions about solutions for lowering health care costs. According to Paul Ginsburg and Nicole Kemper of the Center for Studying Health System Change, this movement toward increased health care transparency results from the convergence of two trends:

  1. Societal demand for accountability from institutions in general.
  2. The “health care consumerism movement,” which makes consumers “assume more responsibility for and control over their health and health care.”

According to Cicero’s findings, while most health plans (83 percent) currently provide just basic provider search tools to members, less than half of these companies offer additional online shopping options such as cost estimats for treatments. It’s clear that a significant competitive edge is gained by health plans providing a broader range of sophisticated and user-friendly transparency tools to consumers.

Additionally, with the cost of health care rising faster than the rate of inflation, there is value in providing the technology consumers need to shop for health care online, much like they do other goods and services.

In fact, the largest health plan in the Pacific Northwest estimated potential savings of $49 million over a two-year period when consumers shopped for treatments for specific conditions such as women’s health and digestive issues. Imagine the savings for all treatments across the board.

Health care transparency is a powerful tool to curb spending. Health insurers have a big opportunity to bring transparency to members. Consumers want it, and employers are demanding it.

About the Author

Scott Decker is president of HealthSparq, a trusted provider of health care transparency solutions to many of the nation’s largest regional health plans and employers. He leads the company’s mission to develop the tools and solutions that consumers need to become empowered health care shoppers. To learn more about HealthSparq’s health care transparency solutions, please visit www.healthsparq.com.

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