HDHPS Create Need for Accurate Price Transparency Tools

HDHP Price Transparency

High deductible health plans (HDHPs) are the new reality as they are the preferred choice of employers and individuals purchasing from the exchanges. The minimum annual deductibles this year are $1,300 for individuals and $2,600 for families. Providers and patients have been slowly adapting to this increase in employee/individual responsibility and the growing percentage it accounts for of a practice’s accounts receivable.

While traditional health insurance plans used to carry the majority of the risk, HDHPs are designed to shift the initial expenses (so the first $1,300 or $2,600) to the individual/family. Many people experience sticker shock when these bills arrive, as they do not fully understand how their plans work.

Healthcare Consumerism

This is why conversations about healthcare consumerism have taken center stage. The need for cost-of-treatment conversations is imperative as is the provider’s ability to accurately provide a quote based on a member’s specific health plan benefits. Providers need to make it a priority that their patients understand what they owe.

Technology Finance Tools

Providers and health plans need to invest in technology finance tools that help both them and their patients understand their cost responsibilities. Tools like patient responsibility estimators can help providers start the conversation with patients and help prepare them with accurate information. Empowering health plan members with this prior knowledge gives them time to determine a financial solution that best works for them and the provider.

According to experts, providers can expect a 50% increase from patient revenue over the next three years; therefore there is an urgency to embracing price transparency tactics. Health Management Technology offers three important  practices that providers can implement to help further healthcare consumerism:

  • Educate staff and physicians about how HDHPs work and how they impact their practice.
  • Provide members with accurate estimates either prior to their appointment or at the time of service. Help them understand what they will truly owe beyond just copays and deductibles.
  • Invest and implement a patient responsibility estimator that integrates with existing workflows and practice management systems.

Source: Health Management Technology. Empowering patients helps improve your bottom line.

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  1. Couple points:
    + The minimum deductible mentioned is for a Qualified HDHP the type of coverage the IRS requires to add a Health Savings Account and thus pay expenses with before-tax dollars. There is no minimum deductible for a traditional HDHP.

    + In both cases – monthly cost for the coverage drives the deductible much higher.

    + One key point about “provider education” – staff, when talking to the person, should discuss the contracted rate their office has with the person’s health insurance company not what I call the office charge.