4c health blog the prudent perspective

The Prudent Perspective


Why It’s Tough to Define “Beauty” in Healthcare

Margaret Wolfe Hunderford was right, when she wrote in her 1878-published book Molly Brown, “Beauty is in the eye of the beholder.“

If beauty is in the eye of the beholder, why isn’t price transparency in healthcare defined by the those actually paying the bills?

The need for “transparency“ in healthcare has woven itself into the healthcare dialogue with the call-to-action growing increasingly loud. There’s one small problem; it’s the parties responsible for the cost of care—physicians, health systems, insurers and other related health vendors—vested interests in the status quo who are attempting to define “transparency“ with a wink and a nod.

Why are we allowing those who have built our dysfunctional health payment ecosystem, a system that has fought any and all efforts to reveal the cost and quality of care administered, define what transparency means?

A growing chorus of frustrated C-level executives who serve as health plan sponsors (and fiduciaries) are pressing for answers, unwilling to accept annual healthcare cost increases that outpace revenue growth. Notably, industry giants Amazon, Berkshire Hathaway and JP Morgan Chase have launched a much-anticipated effort that seeks to, “reinvent[ing] what insurance looks like around benefit design.“ Entrenched health-vendors are combatting this ambitious venture private sector-driven effort, with UnitedHealth Group suing to stop a former employee from working on this effort.

Private sector frustrations regarding healthcare spend and related quality have a powerful public-sector ally in Seema Verma, the well-respected head Administrator of the Centers for Medicare and Medicaid Services. Verma has long-been a relentless advocate for payer-focused transparency be it within private-sector or public sector plans, recently citing, “transparency in health care price and quality is the top priority for the Centers for Medicare and Medicaid Services.“ Medicare and Medicaid serve as the country’s first and second largest purchaser of healthcare.

Here’s the truth: only with a completely independent health spend platform can transparency be achieved for both private and public sector plan sponsors. Vested health-spend interests have near-zero incentive to go along with an estimate, engagement, billing and payment system that better-reflects the business realities of all other cost centers. Furthermore, the necessary data points to better assess and activate change within existing health spend, remain fiercely guarded by insurers.

4C believes that with great insight, comes even greater control. Which is why we’ve built a fully-independent health spend platform, developed specifically around a client-centered real-world definition of “transparency.“ Our 4Clarity product delivers both the necessary health spend insights into key cost drives and the expertise and actionable tools to initiate cost-positive change.

We’ll leave the pitched fight over the definition of transparency to others. We’re ready to show you how our actions speak a whole lot louder than words.

4C’s independent platform empowers those paying the bills. Request a demonstration and you’ll likely agree, “It’s a thing of beauty.”

January 28, 2019