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Pricing and Quality Transparency—Making it Easier to Shop for Healthcare



Comparison shopping is what we do as consumers. We carefully weigh our options when spending money—whether purchasing a new car or deciding where to go to dinner. If we want to buy a new home, we consider school district, location, amenities, and of course, price. We are on a constant pursuit of saving money while getting a quality product or service.


To do this, we use tools and resources to learn more about the value of a product or service before we commit to lay down our hard-earned cash. We scour the internet, look through ratings and reviews, watch video demos of products, and ask our friends and family. A lot of work goes into picking the perfect option.


So why don’t we see this type of transparency in healthcare? Sure, changes may allow us to see WHAT a procedure will cost at a hospital, but how do we know it’s the RIGHT price? When it comes to your health, you want the perfect blend of high quality and low cost. That apex where all charts and graphs converge gives you the true value of healthcare.


The need for pricing and quality transparency

Traditionally, healthcare isn’t handled the same as other products and services. Price and quality information haven’t been readily available, so when it’s time to find a healthcare provider, it can be a guessing game:


• It’s difficult to find information about provider quality.

• Many plan members struggle with the misconception that choosing providers within their network automatically means they’ll pay less for care. The reality is that wide pricing variances exist within networks nationwide.

• Pricing information is hard to come by. Unfortunately, patients may not know how much a healthcare service costs until they receive the bill.


Without knowledge of pricing or quality, consumers may find themselves blindly choosing providers, and overpaying for healthcare without realizing it. And just like any other product or service, prices for healthcare are constantly rising, which compounds the problem. It also leaves employers with a major concern: how can they help plan members save on the cost of care, and in turn, decrease overall medical spending?


Pricing and quality comparison online and on-the-go

Enter Healthcare Bluebook—a tool that gives the information consumers need to shop for the right healthcare provider. This resource (available both by web and mobile app) provides easy access to pricing and quality information when searching for a healthcare procedure. Plus, Healthcare Bluebook offers engagement tools to help encourage users to make wise selections.


Here’s how it works:


1. Employers add Healthcare Bluebook as part of their Meritain Health–administered medical plan.

2. Employees log in when they need more information on an upcoming test or surgery. With a quick search, they can find the Fair Price ™ for that procedure in their geographic area. For the most common procedures, providers are ranked either green, yellow or red (like a traffic light). Green providers offer the lowest prices, and red are the most expensive.

3. Healthcare Bluebook also provides quality information on common inpatient procedures, because higher-quality facilities equal better outcomes. Quality data helps to form a more complete picture of available providers.

4. This valuable information helps employees make an informed decision about which provider to visit.


To further engage employees, employers can choose programs that provide an incentive for using “green” providers, or set a maximum allowable amount for coverage on certain procedures (causing the employee, and not the employer, to pay more for using a higher-cost facility). Employers can also implement scavenger hunts (games) to encourage employees learn how to use Healthcare Bluebook, mobile messaging and more.


But how well does it work?

It’s useful and effective to provide previously unavailable information that helps consumers shop for healthcare. In fact, Healthcare Bluebook reports an average savings of $1,500 per procedure on the most common out-patient services, with clients reporting positive ROIs in their first year with the product. Employers can save up to 12 percent on their total medical spending.


Healthcare Bluebook enables health plan members to shop around for their healthcare—just like they’d shop around for any other product or service. This valuable resource helps make healthcare consumerism a reality.


Want to learn more?

For more information about Healthcare Bluebook and how it helps employers and employees realize healthcare cost savings, just contact your Meritain Health representative.