There are a lot of moving parts when it comes to preparing for compliance with the self-service tool requirement under the Transparency in Coverage rule and No Surprises Act legislation.And, your teams are likely laser-focused on meeting what’s in the mandate. Of course, that makes sense. But, there’s a lot that’s missing for your members in the price transparency requirements. While mandates ensure access to benefit-personalized price information, it puts the burden on people to figure things out. Now, a search for “thyroid” will yield dozens of cost estimates for different services. How can the average person know what to do with that information?
As a healthcare transparency decision maker, you want to ensure your approach meets the mandate, while also delivering an experience people will use to navigate their care options. There are many different solutions in the market today to address the gap in the mandate—from price transparency tools to concierge services—how do you select the right approach for your organization? Integrating guidance into your compliant, self-service tool delivers significant value to your plan, your self-insured groups, and your members. Let’s walk through the benefits.
Gain ROI and satisfaction with guidance-based experiences
High-touch, outsourced concierge services or vendors are one way to help people navigate care options. These services rely on people to cover a wide range of clinical and benefit needs, but the staff aren’t usually experts on your plan or your members’ unique benefit structures. While they can be popular with some groups, they also come with a pretty hefty price tag. Consider how your plan can address this opportunity with a single experience for members.
Adding guidance-based experiences directly in your self-service tool offers an accessible, cost effective, and compliant option for all members–even self-funded groups. There is also a strong return on your investment as members are guided to cost-effective, high-quality care options as they search for care and costs. If high-touch support is something groups demand, your team can also offer high-touch member support by levering a guidance platform in conjunction with your call center team. This supports group needs more cost-effectively than outside services–and your plan gains the brand and savings benefits. The results speak for themselves: our claims-based research shows that tailored, online guidance means members are 4x more likely to use preferred providers.
Uncover valuable insights into member needsÂ
If you didn’t measure it, did it happen? You can gain incredibly valuable member insights through analytics. With self-service price transparency, your members are sharing valuable information with each search and click. This user-level clickstream data is valuable to understand what actions can help your plan save and insights into member needs. Online activities, like what services and specialties people search for, which provider profiles people engaged with, and where they scheduled care or accessed telehealth, provide your organization with insights for member analysis trends and 1:1 support. That’s insight you can’t get from outsourced concierge support services.
Support your membership at scale
With their high-touch approach or focus on a small group of members with specific health needs, concierge services can be costly, and they don’t scale well to a fully-insured population. Most of your members have routine health needs. Whether people need to select a PCP, get virtual care on the fly, or plan for complex care, like a surgery, a self-service, guidance-based solution can help them with their needs. Online guidance is available 24/7 and in different languages. Online price transparency can also support other lines of business, such as Medicare Advantage. And, having a digital guidance experience supports customer service and care teams with phone and print price transparency compliance needs with consistent data.
While price transparency compliance is your target, you can achieve that and more with the right online experience for your members that includes data-driven, proven guidance. Let your members get all the information they need to make smarter healthcare choices all in one place, reducing confusion about where to find the answers and information they need.
