Healthcare Cost Transparency Tools: A Checklist Of What To Look For
(c) Ron Levine
That knee pain that’s been nagging your colleague for weeks has finally pushed him to see an orthopedist. He comes back to the office with a prescription for an MRI and wonders out loud where he should go to get it done.
Good question. The answer could cost him – or save him – money. The price of the same MRI can range from $450-$2,450 in a given market. But he might not know where on that spectrum his MRI will fall when he limps off to get it done – and then be in for an unpleasant surprise when it’s time to settle up.
Enter cost-transparency tools.
These digital tools that compare costs of procedures, appointments, and other medical care at different providers have been mushrooming in recent years. A recent Mercer survey found that 77% of employers in the US offer access to a cost-transparency tool.
Many insurance companies offer their own tools, allowing customers to compare costs of medical services within the insurance network.
But if you have an insurance company that doesn’t offer something like this – or you’re not satisfied with what they do offer -- you may want to look at a tool from a specialty vendor. If you’re ready to hit the market, here’s a checklist that will help:
Check: The Tool Compares All Networks And Medical Centers In The Region.
If your employees have a wide choice of networks and providers, there’s no point in paying for a tool that covers only a handful of them. Make sure your employees can find information on the doctors, clinics, hospitals, and labs they’re looking for.
Keep in mind, too, that people might be willing to drive a few miles if it can save them hundreds of dollars. So make sure your tool covers the entire region, not just the bubble outside your office.
Check: The Tool Provides Accurate Information.
A cost-transparency tool is pretty useless if it’s not, well, transparent. Talk to your insurance broker or ask around to colleagues at different companies about the experiences they’ve had with cost transparency tools. Or take a look at online reviews. Since many of the tools are in mobile-app form, you may be able to find reviews in app stores online.
That said, accuracy can be a challenge. Sometimes, inaccurate information isn’t totally the cost transparency tool’s fault—provider charges are always in flux. Or, a single appointment could turn into a bundle of tests and treatments.
Remind your employees that the tool is a good way to estimate costs, but it gives just that—an estimate. Advise them to double-check prices with the provider before committing to an appointment, test, or procedure.
Check: The Tool Is Easy To Use—And Helpful.
Ask these questions to determine whether your employees will actually want to use this tool:
- Does the tool have a mobile app? If yes, is it available for all operating systems and devices?
- Are the prices it produces clear and easy for users to understand, or is there math involved?
- Does the tool function well, or does it seem to love error messages?
- Which services does the tool compare? Does it only compare prices of medical services (e.g., tests, surgeries), or does it also compare prices of prescriptions?
Check: The Tool Comes With A Guide Or Online Module To Explain Its Value
You can offer the best tool. The one with all the bells and whistles, the one that’s simple to use, the one with a dazzling range of prices. But none of that matters if your employees don’t know why they should use it.
Many insured Americans—about 57%—are unaware that physicians might charge different prices for the same care. So make sure your tool offers some kind of education for your employees, whether it’s a representative who comes onsite to give a seminar, or a prerecorded tutorial online.
Your employees first need to know that the tool can potentially save them quite a bit of money. Then they’ll be more eager to learn how to use it. It may also be a good idea to set up someone at your company as an expert to help others use the tool – and turn sticker shock into action.