DRIVING HEALTH CARE CONSUMERISM VIA TRANSPARENCY
Dec 28, 2015
DRIVING HEALTH CARE CONSUMERISM VIA TRANSPARENCY
TODAYS ENVIRONMENT.
• High deductible health plans
• Narrow networks
• Tiered networks and plan designs
• Cost variability
• Rising health coverage costs
• Consumers are expected to make informed choices
WHAT IF THERE WAS A TOOL…
• That helped consumers know the cost of a procedure?
• And their share of the cost?
• Compared the cost for the same procedure at different places of service?
• By different providers?
• That helped consumers understand that they have choice in where they receive care?
• That provides “shopping advice” on how to save on care?
• Available to them in their home or office or on the go?
A TOOL DESIGNED TO KEEP YOUR HEALTH CARE COSTS DOWN
EMBEDDED IN FIND A DOCTOR Quality
• Provider information• Physician & Hospital• Patient Reviews
Cost• Cost of Care Estimates• Shoppable procedures• Savings alerts
Experience• Engagement strategies• Personalized messages
WHAT IF THE TOOL WAS WHERE THEY WERE ALREADY LOOKING FOR INFORMATION?
…AND WHAT IF THE TOOL WAS POWERED BY ROBUST NATIONAL DATA?
The Blues have a distinct advantage in providing transparency tools due to the breadth and depth of data available
96% of Hospitals and92% of Physicians
100 Million Lives
Every ZIP in the US
UnparalleledConsumer Research
DeeperInsights
AND THE TOOL FOCUSED ON “SHOPPABLE” PROCEDURES.
2013 2014 2015Total
Coverage(Vol % of
Shoppable)
Spring Fall Spring Fall Spring
Short Term+256 new TCs
Additional 113 procedure detail
Additional 87 new category costs
54 new treatment categories
Plus new chronic conditions methodology
86%
424 treatment categories
Long Term+213 additional new TCs
Apx. 105 Apx. 105 100%
617 treatment categories
TRANSPARENCY SOLUTION.
Available Now
FIND A DOCTOR PLATFORM• Treatment cost estimator (170+ procedures)• Physician quality• Physician recognition• Hospital quality measures• Blue distinction centers• Patient reviews of physicians• Mobile-enabled site• Spanish
Available May 2013
MEMBER OUT OF POCKET • Additional procedures added to treatment cost estimator• Member-specific cost estimator• Customer service integration• Displays SelectAccount® balances• Procedure-specific messaging
Standard Solution
AVAILABLE AT NO ADDITIONAL COST
BLUE CROSS’ STANDARD SOLUTION VS. THE COMPETITION.
Transparency vendor capabilities vary*UHC and Aetna have selected geographies
Feature Blue Cross Competition
National treatment cost estimator (claims/network pricing) a *
Out of pocket estimator (benefits and accumulator integration) a a
Quality — physician and hospital a a
Patient review of physician a a
Embedded in plan find a doctor tool a
Mobile a a
Customer service integration a
QUESTIONS?