The type of technology that offers price transparency for rideshare trips, vacation rentals and so many other areas of life is making its way to health care. Not only that, but health care quality data is also becoming more easily available, helping people comparison shop for medical care and services.
Lawmakers mandated some transparency changes in the No Surprises Act and other legislation, including required disclosures by health plans and hospitals. Unfortunately, some organizations are not meeting these requirements or presenting the information in ways that are not easy to understand.
UnitedHealthcare is helping address these issues through multiple initiatives that make quality and cost information more actionable and personalized.
“We know health care quality and cost can vary significantly even within the same city, which is why we offer millions of our members resources to review quality information and cost estimates for more than 820 common medical services,” said Samantha Baker, chief consumer officer of UnitedHealthcare’s commercial business. “By providing this information online, via our mobile app and through our customer care advocates, we are making it easier for them to check on costs and make more informed decisions.”
Samantha said additional resources include everything from an in-appointment tool to help manage prescription costs to an entire health plan that’s built around upfront pricing. There’s even a new way to head off member actions that could result in big, unexpected bills for out-of-network services.
“For many people, surprise medical bills top the list of affordability concerns,” Samantha said. “So, we want to empower our members with timely information that could help them improve their health and perhaps save them money in the process.”
Here are three examples of UnitedHealthcare programs that are built around transparency:
- The Surest health plan provides members with a single, all-in price for hundreds of common services that can be reviewed before deciding on care. Due to the plan’s use of copays (rather than potentially confusing deductibles or coinsurance), members can ahead of time more easily identify and select high-value, lower-cost care providers and settings, in the process reducing out-of-pocket costs by 46%.1 The pre-care transparency is also designed to help avoid surprise bills that could show up weeks after a service with a traditional health plan.
- PreCheck MyScript provides personalized, real-time prescription information during an appointment. It helps the doctor easily identify which medications are covered by a patient’s health plan and the cost for each. The tool may also provide suggestions for other clinically appropriate, lower-cost alternatives, such as generic medications. Plus, it can help streamline the approval process for prescriptions requiring prior authorization by enabling a doctor to make a request within the tool.
- Active member intercept is a program that can help UnitedHealthcare members avoid unexpected charges when it looks like a planned appointment or some other action could create a surprise bill. For example, this might include a phone call when a pre-appointment eligibility check reveals a network issue. The warning may give the member the chance to learn about ways to stay in the network and potentially lower their costs by making a more optimal decision.
“Each of these tools helps shine more light on the health care system,” Samantha said. “Helping to empower our members and their doctors to make decisions that account for quality and cost of services — while also avoiding surprise bills.”
For more information about price transparency initiatives at UnitedHealthcare, visit uhc.com.
1 Surest self-funded 2021 book of business plan sponsors with at least 12 months of incurred experience in 2021 and both medical and pharmacy data within our warehouse ; compared to matched comparison groups from a nationally representative commercially insured database matched by gender, age, urbanicity, and zip3 code using exact matching.