Study shows healthcare payers struggle with these 2 things: 5 takeaways

Health payers are struggling with improving price transparency and its costing them contracts with employers, HealthPayerIntelligence.com reports.

Here's what you should know.

1. Adam Russo, CEO of Phia Group, said the lack of price transparency with payers forced him to self-insure his employees.

Mr. Russo made the decision after being asked to change his company's health insurance plan without any explanation for the rate increases or coverage decreases. He said, "There was never an explanation as to why any of this is happening."

2. Payers are also lagging behind in the technology market, CEO of Vericred Michael Levin said.

He said private payers have struggled with the ACA's platform. His company works with payers and providers to improve price transparency for their customers.

3. When the ACA was implemented, the insurance marketplace became digital. Mr. Levin said payers struggle to implement appropriate technologies to effectively engage the digital platform.

"They don't think about having APIs, structured data, or delivering data to these platforms," he said in the report. "They're focused on delivering healthcare through their plans."

4. Technology and investing in appropriate technology is invaluable, Mr. Levin said.

5. Price transparency and providing customer engagement tools can create consumer loyalty. Mr. Levin supports the idea of a widespread movement to begin transparent practices.

More articles on coding, billing and collections:
How physicians can leverage technology to succeed under MACRA — Insights from Elation Health's CEO
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Owner of Rose's Houston Healthcare Clinic pleads guilty to insurance fraud: 5 notes 

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