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Blue @ Work

The benefits of price transparency in health care

What's it going to cost?

According to a recent Gallup poll, the price of health care is now the biggest financial concern for Americans.1 Without factoring in the cost to see a doctor or paying for prescriptions, employer-sponsored insurance premiums cost the average worker nearly $7,000 for single coverage and nearly $20,000 for family coverage in 2018. And, they aren’t even picking up the bulk of the tab: on average, employers are paying 82 percent and 71 percent of the cost for single and family coverage, respectively.2

With the rising cost of health care and insurance continuing to strain employers and employees alike, price transparency provides valuable insight into the value of coverage — while ultimately helping contain costs.

A move toward price transparency in health care

The price of health care has always been shrouded in mystery. Every service or procedure has a list price, but those can change drastically depending on where employees live, where they get care, and who they see. Until now, these list prices were typically hidden from consumers. The U.S. Department of Health and Human Services recently required hospitals to list prices for all services and items they provide External Site. Though it’s a step in the right direction, this move for increased transparency still comes with complexity.

When looking for how much a service will cost, employees will often find a spreadsheet with entries like, “ACT POC Y/L/M/T/V/W/S − $97.00” and “HC CONVERSION EXT BIL DRG CATH − $7,500.” Not only is it nearly impossible to identify common services, the list prices mean nothing. However, knowing the true cost can help steer toward more cost-effective health care — which benefits the bottom line.

How price transparency benefits your business

Though list prices never reflect what employees will pay, they provide a framework for how much care actually costs. For example, if your employees learn the actual cost of a typical office visit is about six to seven times their copay amount, they might think twice before going to the doctor for a minor concern — or go to urgent care instead of the emergency room. They may also seek second opinions for care, and opt out of certain procedures or tests if they aren’t deemed necessary or don’t change their overall treatment plan.

Helping employees make smart and informed decisions about their health can lead to decreased utilization that contains or lowers an employer's costs. And, they’ll value their benefits once they understand how much they could be — but aren’t — paying out of pocket.

Engaging employees

One of the ways to keep employees engaged in making personalized, cost-effective health care decisions is by making it easy for them to comparison shop for services and procedures. Leveraging a price transparency tool like myWellmark® does just that.

When Wellmark members register for and log in to myWellmark, their personal health care information is at their fingertips. They'll be able to make the most of their benefits with information, resources and insights that help manage spending. The secure website and mobile app includes:

  • Detailed claims information, complete with status tracker and cost details
  • Personalized tools to help them know their coverage and benefits
  • The ability to find in-network doctors or providers and facilities, and see quality scores and patient reviews

To put it simply, myWellmark will streamline and make health insurance easy for employees with Wellmark coverage. Have them log in or register External Site at today.

Have questions about what Wellmark is doing to help increase price transparency in health care? Talk to your authorized Wellmark representative or email us at Send Email.