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Independent reviews improve member and provider relations. BHM’s proven data collection and processing puts claims documentation to work. |
Reported in articles published this week for HealthPayerIntelligence.com, insurers are working to improve the employer-payer relationship because more businesses are pursuing self-funding their own health plans.
For a variety of reasons, some businesses choose employer-sponsored health plans instead of relying on commercial payers. The employer-payer relationship struggles in recent years because of a general lack of price transparency.
This lack of price transparency continues pushing companies toward self-funding health plans. In other areas of life such as the cost of rent or the pricing behind food and beverages at a coffee shop tend to have reasoning as to why prices have increased. However, in the health insurance industry, a clear lack of price transparency is plaguing relationships between payers and employers.
Adam Russo, Chief Executive Officer of Phia Group, spoke with Vera Gruessner about how health payers could keep employers satisfied with their services instead of self-funding their own health plans, Russo answered, “The focus on discounts needs to go away. Right now, in the health plan space, everything is based on discounts. The problem is, from a transparency standpoint, what’s the discount from? Off of what? That number is the unknown. It’s a mystery. There is no price transparency.”
Some companies have implemented technology solutions to address some of these transparency issues.
For example, turning submission data into usable analytics clearly identifies use patterns and uncover performance outliers driving up costs. Payers turn that knowledge into internal process improvements and can share the member use information to address price transparency concerns. Trapping bulk claims data in terabytes of hard to search data structures hides potential analytics in plain sight.
Data is the key to positively addressing transparency concerns for employers; leading to stronger employer-payer relationships.
Independent reviews improve member and provider relations. BHM’s proven data collection and processing puts claims documentation to work. CLICK HERE to find out more.