4c health blog the prudent perspective

The Prudent Perspective

TRANSPARENCY

The Informed Customer is Always Right

There’s a commonly-used saying in the retail and the service industry, “The customer is always right.” Often-expressed via phrases like, “How is your meal…Are you satisfied with your purchase” or the less-preferred, “What can we do to improve the situation?” These phrases and many more, demonstrate the relationship between the market, acknowledged as what the consumer is willing to pay for an item or service, coupled with the level of satisfaction that item or service derives. Together, markets and satisfaction frame the concept of value.”

And then there’s healthcare and the ever-rising costs bore by businesses, consumers and taxpayers and the challenged measure of “value.” Without question, an emergency procedure or treatment that saves a life may be invaluable, but what about all other care-related costs?

How great of a value is the level of healthcare you receive? “My doctor did a great job on my knee surgery, I was up and walking in two days,” a statement of satisfaction, is the easier of the two variables to figure out. The second variable that helps determine the value of healthcare, cost, delivers a headache any smart doctor would be wise to avoid.

Personal and private sector efforts to drill down cost of care provide limitless sources of frustration. For example, insurer’s rates don’t match posted healthcare provider rates, as deep discounts driven off of inflated prices are the currency used by providers for inclusion in plans. Further complicating matters, each healthcare provider takes the procedure-defining terminology and attaches their own abbreviations and unique coding, creating a near-improbable translation and comparison challenge.

Beginning in January 2019, the Trump administration mandated all hospitals to publish prices for services. Though this is a step in the right direction, early signs point to deciphering the breakdown of such prices as too great a headache for the average Joe, as admitted by industry experts. “Meaningless” as affirmed by Kenneth E. Raske, President of the Greater New York Hospital Association in, “Hospitals Must Now Post Prices. But It May Take a Brain Surgeon to Decipher Them” on Jan 13, 2019 in the New York Times. Mr. Raske stated, “To 99 percent of the consuming public, this data will be of limited utility — meaningless.”

Admittedly, the complexity of care and the related billing procedures create an unenviable situation for providers, as demonstrated by a pricey cardiology procedure described as, “HC PTC CLOS PAT DUCT ART” in the aforementioned NYT article.

Recently, the Trump administration has considered furthering health cost transparency efforts by forcing-disclosure of the negotiated discounts between insurance companies and hospitals. When hospitals and insurers are coupled together trying to create an unrecognizable definition of “transparency,” it’s easy to decipher the lines of opposition.

All bets are off on how long it will take government or the vested industry to figure out what transparency means and then how to provide it in a meaningful way may. Fortunately, there’s another solution already within reach of self-insured plan sponsors: 4C Health Solutions.

Transparency is only the starting point. The 4C-delivered transparency can provide the fully-independent visibility, insight and actionable tools completely necessary to consider value. 4C is the only true partner of those paying the bills, neither conflicted nor vested within the current broken health spend ecosystem, ready to illuminate the inefficiencies and ineffectiveness within an existing plan.

With the right health spend insights, detailing accountability, efficiency and effectiveness, 4C is ready to help you ask, “Is our health plan delivering the best-possible value?”

4C is ready to talk about the true value of health spend, are you? Click here to begin the conversation by scheduling a webinar today.

by  
March 20, 2019