By Rob Butler, Founder, Maestro Health
It is official. The healthcare industry has reached its tipping point. There are many differing opinions per when it actually happened, but I’m not sure if it matters. What does matter is: what happens now.
What will happen first is what you have already seen. Industry employer giants like Amazon, Apple and Comcast will repeatedly show up in the headlines as employers seek to take matters into their own hands – driven by the underlying unsustainable economics of healthcare costs that are bludgeoning their balance sheets.
The truth is, employers don’t need to wait for the "Amazons" to create new healthcare companies in order to lower their healthcare costs and help their employees get healthier. Employers just simply need a way to lift the veil on the healthcare experience, so they can understand what they’re paying for and provide their employees with the support they need.
This is already happening and it’s occurring rapidly. The egregious cost practices plaguing the system will slowly be uncovered and years from now, the true costs of healthcare will be a couple of iPhone swipes away. But that alone will not solve the problem. Consumers will need to be taught how to navigate the system and how to “buy” healthcare. The United States is one of the leading nations in the world when it comes to consuming goods, but they will need to be “taught” how to consume healthcare properly and efficiently for this to work.
That means communication has to be simplified and presented in a modern fashion verses the confusion that has traditionally aided and abetted the situation. For example, an Explanation of Benefits (EOB) cannot require a PHD education to be able to discern and understand. In-network and out-of-network discrepancies must go away. Employers will need less vendors and instead choose more comprehensive platforms that can handle the bulk of their needs.
Employees need support to make their way through the healthcare maze.
As employers move to more comprehensive solutions that simplify and lower costs, there is no reason to sacrifice the employee experience. There are people-friendly solutions emerging in the market that help both the employers and their respective employees become better consumers of healthcare.
Vendors have gotten smarter and are offering people-friendly models that provide employees with a transparent experience, so they can understand what to expect every step of the way. One example of this is a people-friendly reference-based pricing model, which includes negotiating pricing on the behalf of an employee and notifying them of the best price option for the best quality of care, prior to services being rendered.
A people-friendly pricing model is designed to provide the support and advocacy required to prevent any financial or legal harm to the employer or employee. In the end, this new model helps employees understand the cost of care – making them better consumers of healthcare.
It’s an exciting time to be in the healthcare industry. Issues like the lack of transparency and support that have been creating headaches for far too long, for everyone, are finally being corrected with innovative solutions. If you are headed to HLTH next week, you’re likely to catch a peek at many of the latest innovative healthcare solutions. You can also catch me at HLTH. I’ll be a part of the panel discussion on “Employers: Owning the Employee Experience” on Monday, May 7th at 3:40 pm PT.
Check out everything else going on at HLTH here.