TRENDSparency

Young families are having an increasingly difficult time staying on budget in this tough economy, where each unexpected expense can cause an uneasy shuffling of priorities – especially when it comes to healthcare. One recent survey from the National Foundation for Credit Counseling found that 64 percent of Americans couldn’t handle a $1,000 emergency. To show how the average American is handling such costs, Anna Mathews’ personal finance column in Sunday’s edition of the Wall Street Journal showed us how TaKeisha Woodson, a credit analyst, saved nearly 50% on a prescription simply by taking advantage of change:healthcare’s Ways to Save Alerts™. But there is much more to TaKeisha’s story.

First Horizon National Corporation is a self-insured employer that offers the change:healthcare cost-comparison tool to its employees. TaKeisha is married to a school teacher, has two young children, and just like most growing families, she must juggle the challenges of making smart purchasing decisions with the need for quality care. In addition to the savings referenced in the WSJ, in May of this year her ten-month-old son became sick and was prescribed antibiotics by his pediatrician. TaKeisha arrived at the pharmacy to pick up her son’s prescription and was shocked to see a $100 price tag for a basic antibiotic. Instead of simply accepting the price at the pharmacy, TaKeisha knew she had options. Once she returned home, she logged onto her computer and using the change:healthcare Cost Lookup™ tool, found the same medication at nearly half the cost at another nearby pharmacy. In addition, with the change:healthcare cost comparison tool, TaKeisha will continue to receive proactive e-mail alerts on her routine prescriptions and doctor visits, letting her know how she and her family can save money in the future.

Her story is a testament to the power of actionable cost transparency – and it is just one of many. Through access to pricing information and a proactive outreach strategy that helps consumers take advantage of savings opportunities, TaKeisha is one of thousands of employees who are able to maximize the value from their healthcare benefit.

It definitely makes you wonder how much our healthcare system could save if everyone had access to the same tools as TaKeisha. Stay tuned for more savings stories from patients and employees …

With the passage of the Affordable Care Act in 2010 and the monumental changes likely to occur in how healthcare is purchased, delivered and reimbursed, it only felt natural for me to make a change in my career.  

I’ve spent the past eight years in the pharmacy benefit management industry with CVS Caremark, so I was fortunate to work with a broad cross-section of health plans and large self-insured employers who were all interested in better managing healthcare costs.

While some focused on reducing pharmacy utilization to curb costs, others took a more holistic approach by seeking to drive better adherence and higher rates of gap-in-care closure as their way to ‘bend the trend.’ Although I may have chosen pharmacy, this same debate exists in many other areas of the healthcare universe, whether you look at diagnostic imaging services, wellness programs, or disease management. Essentially, you’re either focused on the near-term or you’re focused on the future.

Regardless of the approach, there is a general lack of understanding among employees about what their care actually costs. I constantly heard from HR benefit managers, “Our employees don’t understand that their $30 co-pay is not the entire cost of the prescription!” or, “If our employees only knew what prescriptions cost us, they might make a different and less expensive choice.”

For me, this is how change:healthcare is changing the game. Not only are they making personalized, plan-specific, cost-and-quality information available to the employees, they are also highlighting savings opportunities to make them understandable and actionable.

As I started to think about this in the context of healthcare reform and what some have referred to as the “retailization” of healthcare, I was drawn to the proactive, personalized approach change:healthcare is taking.

By 2014, healthcare exchanges will likely be a reality, and the individual market will likely be a more meaningful segment of the healthcare marketplace. Whether you believe the McKinsey survey that predicts 30 percent of employers will drop coverage or the Mercer survey (PDF) that indicates only 8 percent will drop, the individual market only will continue to grow and a greater number of individuals accustomed to having their benefits chosen for them will now shop and pay for those benefits themselves.

With this change comes the need for education, information and tools to assist those individuals with how best to spend their hard-earned dollars on healthcare. As employees continue to bear a greater portion of healthcare costs each year and with the market clamoring for this information today, we are in a great position to help fill a major gap in the healthcare system.

If my first month at change:healthcare is any indication of the marketplace’s demand for healthcare cost transparency, I can’t wait to see what the future holds. And with that, all I can say is get ready – it’s going to be an exciting ride.