Federal price transparency rules for health plans will undoubtedly influence your member experience going forward. The self-service tool requirements in particular promise to deliver a lot for members as they make decisions about their healthcare. With an easy-to-use and accurate cost estimator available on health plan websites, members can interpret all available data, feel empowered, make informed decisions, and act on them. Sounds great, right? It is! And now that all plans are required to meet a transparency mandate, we’re going to see those who provide a tool members will appreciate and use often differentiate themselves from the pack.
To take the Transparency in Coverage mandate to the next level and create a competitive advantage, we suggest three strategies to expand on the self-service tool requirements.
Strategy #1: Guide
The primary focus of the mandate is all about delivering more data. And this is a great step forward, as we consistently see in our research that people want more data when it comes to their healthcare. The issue with more data, however, is how to help members make sense of it and not get lost in a data jungle. To help address the too much data issue, health plans have an opportunity to tailor their experience and guide their members. In fact, recent research revealed that 70% of all respondents are interested in health plan guidance.
The key to guidance is to center your process on helping members find the right provider at the right time for the right price. The goal should be to help them find, understand, and compare healthcare options in a meaningful way. Providing contextualized messaging, offering detailed provider profiles that help members make decisions (like whether the selected provider is in-network or accepts new patients), and including other guidance elements (like noting whether a provider is a PCP) are some ways to help.
Strategy #2: Unify
When searching for a provider, your members want a digital experience that aligns with other retail and online experiences. They want to be able to compare prices on healthcare services the same way they do when searching for a flight. This means it is important to avoid a fragmented online experience and instead provide a unified solution. Let them accomplish all tasks related to their healthcare journey in one place—find a provider, look up personalized out-of-pocket cost for services, understand the cost impact of each provider visit toward health benefits, find care alternatives, and more. Essentially, let them book their flight, select their seat, confirm baggage needs, and protect their trip all in one checkout experience.
Strategy #3: Connect
You care about your members and want to provide a great consumer experience with a self-service tool that connects the dots between finding care and getting care. With the right solution, members can find a provider, access personalized out-of-pocket costs, connect to care immediately via telehealth, or make an appointment for an in-person visit. We know that more than 9 out of 10 people want scheduling a healthcare appointment to be as easy as booking a dinner reservation online, and industry experts agree. Gartner noted in its 2021 Hype Cycle for U.S. Healthcare Payers that a member’s medical shopping experience is most effective when it includes other decision-making elements like online scheduling information to book care.
Ensuring federal compliance is critical, but as industry experts like Gartner point out, the real strategic value from transparency comes from creating an experience that differentiates your organization in the market and guides members to care alternatives. We hope these tips help you on your way and inspire you to get ahead of the mandate deadlines for your members—and for your business.
Contact HealthSparq today to learn how you can bring an intuitive digital experience to members, guide them to the providers and care they want and need, and exceed federal compliance requirements. Your compliance folks will thank you, too.
