New Medical Price Shopping Technologies Reduce Treatment Costs

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Santa Clara Conference Center
Venue for the 2013 Health 2.0 Conference

Mike Allen: “Employers looking to lower health expenses should help workers shop for medical treatment.” 

New technologies are rapidly evolving that engage employees in finding cost-effective health care, according to Lew Altman, a leading healthcare consultant and speaker at the 7th Annual Health 2.0 Conference held in the Silicon Valley.

The conference highlighted a number of new medical price shopping platforms that have entered the market since the well-funded debut of the Castlight in 2010. Let’s take a look at the companies which demonstrated at Health 2.0 plus several others to get a sense of the price shopping tools available for employers, health plans, insurers and brokers.

Change Healthcare targets health plans and self-insured employers and has recently received $15 million in funding.  They demonstrated their user-friendly online Healthcare University which teaches consumers the fundamentals of health insurance and price shopping.  This platform is being successfully used at BlueCross of Minnesota.     The “University” is part of a platform which also includes the  Transparency Messenger which provides consumers with personalized messages about savings opportunities based on their medical record.  For instance, the system can generate an email alert to patients using an expensive branded drug to let them know that a low-cost generic is now available. Change Healthcare touts a national client base of employers and health plans covering lives in all 50 states.

New entrant  PokitDok  was launched in 2012 to help patients solicit price proposals from multiple providers.   While PokitDok primarily focuses on signing up consumers, CEO Lisa Maki indicates that they have recently introduced functionality for business owners and have raised $4.0 million to begin national expansion.

Other new start-ups include HealthInReach  which offers scheduling and discounts for both medical and dental procedures in the Los Angeles area and MyDocTime which demoed a doctor and dentist scheduling service which finds a provider who can take you immediately.  Two other firms offer price shopping for dental services and both have special programs for employers.  Healthsouk currently covers a number of California markets; Brighter offers a similar service in Los Angeles and plans a national expansion backed by major venture capitalists Mayfield Fund and Benchmark Capital.

Several more established players that offer programs for employers and national coverage did not present or exhibit at Health 2.0.  These leaders include GoodRxFairHealth, and Castlight.  Detailed descriptions of these offerings can be found at their websites and at this site’s App Directory.

Should employers be jumping in and offering medical shopping platforms to workers?  Yes, but proceed carefully and consider the following factors as you develop your requirements.

1. Geography – Although all of the services noted above have expansion plans, many currently offer only limited geographic coverage.

2. Depth of provider coverage – a well-established Bay Area periodontist who has tested several of the dental platforms told me that “most of the dentists were either recent dental school grads or not people I would refer to.”   Make sure you understand the depth and quality of the network you offer your employees and manage their expectations accordingly.

3.  Go for the big savings – many offerings primarily help employees reduce “out-of-pocket” costs which account for only about 16% of total medical expenses according to a 2007 study.  This is a good place to help your employees get started with medical price shopping, but keep in mind that the larger savings will come from programs which engage employees in reducing the “over-the-deductible” costs which account for 84% of total medical spending. 

At this point, none of the firms noted above are promoting their ability to generate “over-the-deductible” savings although Castlight appears to be putting together the tools that will make this possible.  Take a look at their  recent study showing that a knee replacement in Los Angeles at a quality provider costs  $60,000 less than the same procedure at a lower quality provider!

Industry players including Lew Altman, Lisa Maki and many others believe that employees will increasingly play a more active role in managing their own health, including shopping for treatment.  Companies, health plans, insurers and brokers all have an opportunity to provide workers with the knowledge and tools they need to make this transition.

 

October 15, 2013 |

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