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Health Plans and Self-Insured Employers: Are You Ready to Run?

Doug Ghertner President and CEO

Doug Ghertner
President and CEO

As individuals and businesses alike struggle to reign in their healthcare costs, high-deductible health plans are becoming more and more common. On the public exchanges alone, more than 80% of the 8 million enrollees have opted for either silver- or bronze-level health coverage, with average deductibles of $3,000 and $5,000, respectively. Similarly, more than 50% of large employers say they’ll offer more high-deductible health plans in 2015. And nearly one in three – 32% – will only offer this plan type next year (that’s up from just 22% in 2014). [1]

Whether purchased on public exchanges or provided through employer-sponsored insurance, high-deductible health plans put greater out-of-pocket responsibility on consumers. The good news, according to research done by Change Healthcare across a number of its clients, is that as deductibles/out-of-pocket costs increase, so does a consumer’s willingness to engage in their healthcare. With that in mind, it becomes all the more critical that plan sponsors ensure the tools and resources are available to meet this higher level of engagement.  (Look for more on our study findings in our white paper titled “Higher Out-of-Pocket Costs Drive Healthcare Consumerism”– to be released in November.)

What should health plans and self-insured employers do with this “good news”? Run with it! Give your newly captive audiences what they want and need: cost transparency and consumer engagement tools that educate and empower them to make better healthcare decisions – decisions that weigh quality and cost and make healthcare more affordable for us all.

Want to learn more? Engage with us today.


[1] “Large Employers’ 2015 Health Plan Design Changes,” National Business Group on Health, August 2014

Facilities, Not Physicians, Account for Widely Varying Healthcare Costs

Doug Ghertner President and CEO

Doug Ghertner
President and CEO

This week, Change Healthcare released its Healthcare Transparency Index for the first quarter of 2014.  In it, we look closely at the impact of facility fees on total healthcare costs.  As many of you I’m sure are familiar, such fees often account for widely varying healthcare prices (rather than the doctors’ fees that are commonly blamed for escalating healthcare costs).

According to our Q1 2014 HCTI, knee and hip replacements demonstrated the greatest degree of variability depending on where they were performed – from ambulatory surgery centers to private hospitals to academic medical centers – with prices ranging by 1,687% and 1,132%, respectively.  In other words, the facility fee associated with a knee replacement can vary in price from $1,803 to $32,225.  And for a hip replacement, facility fees range from $2,613 to $32,190.  Other procedures showing substantial price discrepancies at the facility level include CT scans (469%), ultrasounds (350%) and vaginal deliveries (319%).

The takeaway for consumers: You can obtain high-quality, lower-cost care from YOUR doctor by simply asking them where they have privileges to perform a surgery or deliver a baby – and then using that information to identify the highest quality, lowest cost facility for obtaining care.

The call-to-action for plan sponsors: Take the time to educate your members and employees on appropriate point-of-care utilization and empower them with tools to comparison shop for healthcare services – it can drive significant savings all-around.

Want to learn more about the medical and dental services that vary the most in price and, as such, provide the greatest opportunities for savings? Download our latest HCTI.

Want to know how Change Healthcare can help educate and empower your plan members and employees to make wiser healthcare decisions – weighing both quality and cost? Engage with us today.

Study: More Than Half of Major Employers Are Looking to Transparency to Help Reign in Healthcare Costs

Geoff Kilgore Senior Vice President, Sales and Account Management

Geoff Kilgore
Senior Vice President, Sales and Account Management

Change Healthcare recently sponsored a study to gauge where major employers are in their strategies to bring healthcare cost transparency to their employees.  Study participants included representatives from 30 companies, including 20 members of the Fortune 500. The results of the study will not only help shape our company’s product roadmap, but also provided important insights into employers’ cost transparency and employee engagement priorities – and the measures that matter most to them in determining the success of related efforts.

Not surprisingly, the study showed that employers have an increasingly deep appreciation of the value of helping employees understand healthcare cost and quality information.  More than 50% have done at least some formal evaluation of transparency providers with the primary motivation being to assist the growing number of employees enrolled in high-deductible health plans.

When asked about the things that matter most in a transparency solution, more than 80% of employers ranked the ability to provide comparative costs for diagnostic and other medical procedures as most important or “Critical.”  The remaining employers consider this functionality “Important.”

Employers’ other top priorities include:

Access to quality information.  Approximately 70% of employers consider this “Critical,” with the remaining 30% ranking it as “Important.” One study participant noted, “It’s essential for employees to understand that they are not taking a risk when they comparison shop for healthcare. If they know they can save money and get a better outcome, it should be a no brainer!”

Availability of pharmacy costs. Of the more than 90% of employers who ranked access to pharmacy costs as “Critical” or “Important,” many suggested that, in many ways, it is the simplest way for employees to understand the value of shopping for healthcare, as pharmacy services allow for apples-to-apples comparisons.

Proactive alerts that identify opportunities to save on recurring medical and pharmacy services. More than 80% of employers support this kind of proactive outreach.  Interestingly, some employers who said they had only some interest in proactive outreach changed their minds when they learned that 60% of employees act on proactive alerts and, afterwards, are four times more likely to comparison shop for care and 70% more likely to choose a higher quality provider. This reaffirms that employers are not only interested in immediate savings, but also value-based decision making over the long term.

At Change Healthcare, we believe that the most effective cost transparency and consumer engagement solutions should provide all of these capabilities – and more.  It’s why we’ve built our Engagement Platform the way we have.  It’s why we remain a leader in the consumer engagement space.

Want to see how Change Healthcare can help your business reign in its healthcare costs?  Engage with us today.

Targeted Messaging to Complement Existing Efforts Around Health and Wellness

Clayton Nicholas Vice President Marketing and Strategy

Clayton Nicholas
Vice President
Marketing and Strategy

I’m excited to share that Change Healthcare recently launched its newest solution for health plans and self-insured employers looking to improve population health and reduce healthcare spending via consumer engagement.  Our Targeted Engagement Alerts use proactive, targeted messaging to support efforts around wellness, chronic care management, medication adherence and point-of-care optimization.  Architected to complement, not compete with existing wellness and preventive care initiatives, they help plan sponsors:

  • Improve the utilization of high-quality providers;
  • Improve population health outcomes; and
  • Control their healthcare cost growth trends.

For consumers, Targeted Engagement Alerts support:

  • Better understanding and utilization of their healthcare benefits;
  • Improved health status with higher usage of prevention and wellness services; and
  • The selection of high-value providers.

The time for Targeted Engagement Alerts is now. Studies show that well over half of employers – 61% to be exact – consider employees’ health habits the number one challenge in controlling healthcare costs.  Interestingly enough, 56% of consumers want help in managing their health status and related risks.  With Targeted Engagement Alerts, plan sponsors and consumers alike get what they need.  (Plus, for health plans, Targeted Engagement Alerts provide an effective, non-plan design-driven way to improve Medicare Advantage Star ratings, and may qualify as a quality improvement activity under the MLR calculation.  The solution also supports accreditation or reaccreditation for URAC and NCQA initiatives for disease management, case management, wellness and health promotion.)

Change Healthcare piloted Targeted Engagement Alerts with Cerner Corporation in 2013 with strong results – and we look forward to implementing the tool with several large health plan and employer clients this summer. Let us show you how they can help your organization achieve its health and wellness goals. Engage with us today.