2014 AIM Specialty Health. All Rights Reserved.
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2 The New Cost Transparency Engaging Consumers to Become Educated Specialty Care Shoppers Scott Gerhart Regional Vice President Central Ohio Health Service Area Anthem Blue Cross Blue Shield Kevin McDermott, MHSA Vice President Business Applications and Data AIM Specialty Health 2
3 Objectives Discuss the widespread movement toward enhanced cost transparency for consumers and the role of key stakeholders in the industry Learn about the latest innovations in AIM Member Engagement and how it addresses transparency gaps and challenges Hear first-hand a health plan s journey to greater transparency, the provider response, and best practices for implementation in your market 3
4 The Market is Ripe for Disruption Consumer Employer Government Payer Provider 4
5 Consumer Patients want more say in their health decisions and are rapidly adopting transparency tools How willing would you be to go to a select set of doctors, hospitals or clinics determined by your health insurance company if you could save 10% - 15%? Source: WellPoint Member Survey 2010 Deloitte Consumer Survey % Would use a website telling them price of healthcare services 65% Would make a change specific to MRI or other advanced imaging 5
6 Employer Responding to consumer market demand with new ways to manage costs Strategies To Help Employees Compare Healthcare Services NBGH Plan Design Survey - 72% will have online transparency tools available to their employees in
7 Government Still the largest payer ACA and Exchanges CMS is publishing payment rates and quality measures State-based transparency initiatives 14 States Require Payers Report Payment Rates Released Charge and Payment Data on Most Common Inpatient Admissions and Outpatient Services in 2012 Source: APCD Council. All-Payer Claims Database. Available at Accessed September 24,
8 45 States FAIL on Transparency Completeness 50 state report card issues an A grade to only 2 states AK HI WA OR NV CA ID AZ UT MT WY CO NM NM ND SD NE KS OK MN IA MO AR WI IL MS IN MI TN AL KY OH GA WV SC PA VA NC ME VT NH NY MA MD NJ DE RI CT A Massachusetts and Maine C Colorado, Virginia, and Vermont F Remaining 45 states TX LA FL Source: Catalyst for Payment Reform, 2 nd Annual Report Card on State Price Transparency Laws 8
9 Payer Consumer experience is in top 3 objectives for 2015 Value Stage 1: Basic Tools Stage 2: Integrated Platform Stage 3: Advanced Applications Stage 4: Employer Portal Stage 5: Shopping Network Costs Decrease and Value Increases Cost But there is a Challenge: DATA Source: The Commonwealth Fund
10 Provider TWO to TEN times variation in cost and a shift towards population health management Office visits with diabetes screening, CT scans, and MRI are the three most variable-priced services in health care - 300%, 796% and 451%, respectively Researchers reported that price variation was the #1 driver of cost differences among inpatient hospital services for the health plan studied Sources: Change Healthcare. Healthcare Transparency Index 2013 Q4 Report. May 7, Available at The Commonwealth Fund. Variation in Inpatient Hospital Prices and Outpatient Service Quantities Drive Geographic Differences in Private Spending in Texas. June 18, Available at 10
11 AIM Member Engagement Addresses transparency gaps for consumers, employers, and payers Designed to support reference-based benefit design approaches being implemented by employers across the country Information is provided directly to consumers empowering them as active participants in their health care decisions Integrates directly with clinical appropriateness review so consumers receive quality care at a more affordable cost Specialty Care Shopper SM for Imaging Specialty Care Shopper for Sleep Specialty Care Shopper Cost Inquiry Specialty Care Shopper for Surgical Procedures 11
12 Process and Benefits High-touch, High-tech Servicing Site Assessment Voluntary provider registration through OptiNet Payer adds unit cost data per exam Assist Ordering Doc: Site Selection Reviews sites based on cost, quality, and accreditation Recommend Site to Consumer If non-preferred site selected, contacted to suggest alternative highvalue site 12
13 The Shift to High Value Care Sustainable program impact in first to market states 2 Industry Innovation Awards 12.5 Million Consumers Being Served REDIRECTION EXPERIENCE Indiana Ohio ELIGIBLE CASES 25-30% 25-30% CONSUMER REDIRECTS TO HIGH VALUE PROVIDER 14-16% 10-16% AVERAGE SAVINGS PER CASE $764 $683 ANNUAL SAVINGS FROM REDIRECTION ANNUAL SAVINGS FROM HOSPITAL RENEGOTIATIONS $0.32 PMPM $0.55 PMPM $0.37 PMPM NA Source: AIM and provided Health Plan data Indiana results based on 9/13-8/14 shopper direct impact data for 900k lives; Contract savings estimated based on change from unit costs study in April 2014 Ohio results based on 9/13-8/14 shopper direct impact data for 670k lives 13
14 National Attention for Member Engagement The value of price transparency is clear: $220 per test in total health system costs Price Transparency For MRIs Increased Use Of Less Costly Providers And Triggered Provider Competition, Vol. 33, No. 8, August
15 What s Next The Member Engagement roadmap More Services More quality measures More product lines of business Coordinated benefit design 15
16 The Payer/Provider Perspective A Real Life Case Study 16
17 Real-Life Payer Perspective: Ohio Story Why Ohio invested in transparency Skyrocketing trends Unjustified provider costs The timing was right Actively engage the third leg of the stool employers and consumers 17
18 Real-Life Payer Perspective: Ohio Story Engaging providers through OptiNet was not enough Phase 1 Cost and quality information available to providers at precertification Limited Impact from Providers Prompted Consumer Engagement Phase 2 Cost and quality information available to consumers via outbound call P1 P2 18
19 Real-Life Payer Perspective: Ohio Story Impact and market response Nonintrusive, educational approach Targeted counties then expanded to entire state Immediate contact from hospitals Responses ranged from disinterest to outrage 19
20 System Case Study The 5 stages of provider transparency Denial: This won t catch on. Anger: You can t do this to us. We will fight this. Bargaining: What is this really all about? What are my options? Depression: Get state legislators, Medical Association involved. Adjust scheduling. Acceptance (Finally!): Lower rates to avoid steerage. Consistent rates. Easier to roll out future products
21 Impact to Ohio Providers Basic principles of economics Behavior Shift Avoiding Abrasion Role of Publicity Monitor costs Lower rates Fixed pricing Be proactive Stress the importance of transparency and education Stand firm Challenges will come when first to market Blueprint for others to follow Quantifiable savings This is where the market is heading Providers Can t Rely on Reputation Alone Anymore 21
22 Things to Consider for your Transparency Strategy Lessons Learned Lead with quality Highlight educational approach and consumer choice Hold providers accountable for explaining to consumers why they cost more Stay firm no exceptions Keys to Success IT IS THE RIGHT THING TO DO! The market will adapt Employer groups will support you Consumers will appreciate you This is a market differentiator This too shall pass 22
23 DISCUSSION INSIGHTS 23
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