Infographic: How Payers and Providers Should Approach Price Transparency Changes

Monday, January 6th, 2020
This post was written by Melanie Matthews

The Centers for Medicare and Medicaid Services (CMS) recently released two rules (one final, one proposed) to advance the Trump administration’s agenda to create a transparent healthcare marketplace. The rules are designed to spur competition that will benefit consumers by making hospital prices and out-of-pocket costs much clearer and to remove the secrecy surrounding contracted prices. If the rules are enacted in a way that’s consistent with the current proposals (which is a big if), the impact to consumers could be wide ranging, but will heavily depend on how payers and providers respond, according to a new infographic by Oliver Wyman.

The infographic outlines considerations for both payers and providers to address these price transparency changes.

2019 Healthcare Benchmarks: Patient EngagementThe perennial challenge for healthcare organizations as they continue to develop and refine programs aimed at improving healthcare quality while reducing costs is engaging patients in these initiatives. Actively engaged patients have been shown to have lower costs and improved outcomes.

In fact, a recent study released by Humana on its wellness rewards program, Go365®, found that high-engaged members had lower healthcare cost increases than members with low or medium engagement. These highly engaged members paid a per member per month average of 22 percent less in healthcare than low-engaged members, had 35 percent fewer emergency room visits and 30 percent fewer hospital admissions than low-engaged members and had 11 percent more preventive doctor’s office visits than low-engaged members.

2019 Healthcare Benchmarks: Patient Engagement is the third comprehensive analysis by the Healthcare Intelligence Network of programs aimed at improving patient engagement, including how patients are identified for patient engagement interventions, populations presenting the most significant challenges, program components and results and ROI, based on responses from over 50 healthcare organizations to the October 2019 patient engagement survey.

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