Home Health Insurance Bringing Real Transparency to Open Enrollment

I read an interesting report recently that claimed the average insured individual spends just minutes evaluating their coverage options during open enrollment. While not surprising, it is interesting when you think of how important this decision is when it comes to how that person ultimately receives care – not to mention the impact to their pocketbook. I don’t claim to have the answer… but I have some ideas.

In the last few years, payers have spent millions of dollars on transparency tools that allow members to better understand the cost of care. Want to know how much that knee surgery will cost? There’s an app for that. Now, what if that same member wants to know how efficiently they used their insurance plan over the year. The answer is not so simple.

My theory is that payers don’t provide their members with adequate information to thoroughly evaluate plans during open enrollment. In fact, it’s almost impossible to do, so shoppers don’t spend much time looking at the grass over the fence. As payers, we know what prescriptions a member fills, which doctors they see, and the preventative services available to them that they may or may not use. Based on that information, can we do a better job of providing our members with some guidance? That might mean confirming that the plan they have is a good fit, or providing them with alternative plans that may work better. Even simpler, can we show our members an end of year statement that calculates what their costs would have been without insurance?

Before we go any further… I get it. Why would payers want to highlight lower cost plans to their members? Actuarial scientists beware! But while a member may select a plan with lower premiums, let’s look at the big picture: how does providing such information influence the lifetime value of that member? As insurers, we want our members to believe that we keep their best interests front and center when it comes to balancing the cost and quality of healthcare. To truly earn that place, how transparent do we need to be?

I would argue that all costs need to be on the table.

If you want a member for life, demonstrate that with each passing year. Use the rich information you have available to recommend the best possible plan for their needs, and provide them with information and tools that help them find and receive cost-effective care without sacrificing quality. This is what our members are asking for. And they have been asking for a while.

I wonder which payer will be the first to really listen and act. Who will be the first to recognize the lifetime value of their members?

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Matthew helps forward-thinking organizations develop digital solutions that captivate and engage consumers. He speaks four languages fluently (that’s a lie, he struggles with English) and is an avid runner and CrossFit athlete (that’s a lie too). Matthew likes to relax with family and friends and eat good food (okay, that one is true).

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