shopping for healthcare services
Employee Benefits

Let’s Put Some ‘Black Friday’ in Our Healthcare Spending

Steve Harris, CEBS
Steve Harris, CEBS
Development Officer, Employee Benefits

Whether it’s Black Friday or Cyber Monday…this year I’m glad to hear some retailers are scaling back their hours so people can focus on what matters most this holiday season. We all cringe watching shoppers on the news camp out for hours and mow people down to snatch up the latest bargain. The real irony…if we shop for healthcare services the same way we stalk a 60-inch TV, we can all make greater strides to flatten the cost trajectory of healthcare. There are even ways we can set up your plans to incent your employees to pocket some of the savings.

Using Dallas as an example, because that’s where I’m located, we have some of the largest retailers like Neiman Marcus, JCPenney, and, maybe soon, Amazon’s HQ2, headquartered in our home town. So, needless to say, we know how to shop! With that experience at my fingertips, here’s a three-step process for any employer hoping to put a little “Black Friday” in your healthcare plan. 

1) Offer A High-Deductible Plan

Milton Friedman wisely quipped, “Nobody spends somebody else’s money as wisely as he spends his own.” Putting in a high-deductible plan enables your employees to be economically rewarded for shopping around and strategically aligns your insurance plan to cover infrequent and high-cost medical events. Among firms offering health benefits, greater than 50 percent of employers with 200 or more workers offer a high-deductible health plan as an option. And please don’t call it a high-deductible health plan. How about putting on your marketing hat and calling it something like a “Health Savings PPO”?! It just has a better ring to it.

2) Arbitrage Your Network

When it comes to choosing the right network for your health plan, new choices have emerged that leverage health system ACO and narrow network models, reference-based pricing, and value-based point of service designs. However, employers and their people must go beyond simply choosing a network at the time of enrollment.

Once your health plan/network is in place, the employer must then teach employees to exploit hidden value within the network throughout the year. Sixty percent of medical and pharmacy claims come from non-emergent services. As an example, three facilities within a five-mile radius in Dallas-Fort Worth offer the same in-network MRI for prices ranging from $600 to $3,000. That enables Holmes Murphy and our clients to use billions of claim records to uncover the black box of health pricing. It’s worth asking why your leadership team is forcing you to pay 5 times more for the proverbial “flat screen TV” of healthcare.

3) Shop With a Trusted Friend

Transparency laws are now enabling big data analytics and artificial intelligence (AI) to quickly analyze over a billion national health claim records for price and quality comparisons at the push of a button. But buying healthcare services isn’t like buying a TV. The best health price transparency providers have realized that shopping for care is best delivered when technology is married with a health navigation service that brings in a trusted professional or health pro to assist. As an example, there are numerous types of MRIs, so having a personal concierge to confirm with the doctor and help navigate options enables my family to build trust with a pro who can help navigate a complex system and doesn’t have a financial interest in the outcome. To revolutionize the system, we need to help our employees act on information, not just provide data.

Many of Holmes Murphy’s clients are well on their way to creating a shopper’s mentality among their health plan enrollees. Healthcare navigation, advocacy, and pricing transparency programs can bring annualized savings anywhere from four to 24 times the cost of the service. As towns across the U.S. continue to reinvent the shopping experience, we anticipate more companies to get on the “Black Friday” bandwagon when it comes to savings in their health plan.

The best part is we can all be empowered to score health deals that would make a Walmart clerk gush just by picking up the phone.

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