Let’s talk pricing: How payers can navigate tough conversations with members

Doctor with patient
Maslansky + Partners President Lee Carter offers tips for pricing language. (Getty/wutwhanfoto)

“How do I navigate the conversation around healthcare pricing?” is a common question coming from Lee Carter’s healthcare clients.

Carter, the president of language strategy firm Maslansky + Partners, works with hospitals, pharmaceutical companies and insurance companies grappling with that hot-button topic. And according to Carter, language not only matters, it can make all the difference. 

Healthcare pricing is at the top of mind for almost everyone in 2019, from providers and big pharmas to politicians and consumers. Carter speaks wearily of the plans floating around Congress that threaten the entire healthcare industry, including Medicare for All and calls to end private health insurance all together.


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Lee Carter (Maslansky + Partners)

She says that making any sort of changes is going to be a massive organizational and monetary undertaking, one beyond the scope of most consumers’ understanding

6 tips for crafting pricing language

  1. Don't pass the buck. Pricing is a complicated issue, but resist the urge to blame another division of the industry for driving up costs.
  2. Demonstrate what investments lead to. In publishing pricing, be sure to show payers, providers, consumers how you're continuously investing in the product or service you deliver.
  3. Show how you're committed to affordability. Cite all the things you do that tackle the root causes that are driving up costs as well as your patient assistance programs. 
  4. Communicate goodwill. Don't just state that you're revealing pricing because it is mandated, instead demonstrate that it is part of the organization’s immediate effort to increase transparency, 
  5. Segmentation. Healthcare companies may need to view their consumer audience as two segments and design a two-pronged message to address consumers who are and those who are not familiar with the high cost of healthcare.
  6. Make it clear for consumers. Don't hide behind industry jargon. Demonstrate the real transparency needed for people to understand what they're going to pay and to enable them to compare pricing across providers.

There is clearly a disconnect. Carter says that many of her clients, especially insurance companies, wish that consumers better understood the work that goes on behind the scenes when bringing a plan to market, or the backend forcing companies to raise premiums. 

“Everybody looks at it like it’s an isolated thing,” Carter says about payer pricing decisions. But in fact, pricing is interwoven, driven by insurance, pharma, hospitals and third parties, and so the biggest mistake any of these industry players can make is shifting the blame from pharma to payer to provider.

RELATED: Study: Per-member spending growth in Medicare, Medicaid is slow

“None of that matters,” Carter notes. “For people, it’s all one experience to them. They just see they used to be covered and now they are no longer covered.”

So, to combat this lumping into one entity, Carter recommends that her clients put themselves in the shoes of the patients and politicians in order to make themselves relatable. 

At its core, the most important part of pricing language is empathy. Carter notes that during the midterm elections, the Democrats rallied messaging around healthcare to gain support. Politicians are using the fear and personal aspect to draw crowds. 

Carter also noted that after empathy, payers need to commit to transparency. The truth can be very powerful and when it is done right, Carter says, this strategy works. 

First, she recommends reframing any argument by starting with the person you are talking to and addressing his or her real concerns. 

“You can address challenges without understanding empathy and the target audience,” she said.

Second, just saying a company has price transparency is not enough. The challenge is relaying the information in a way that consumers can easily digest because what is currently out there is very confusing to the average consumer. 

As an example, Carter talks about how Bank of America advertised services after the recession. The bank’s Clarity Commitment promised to include a one-page summary for every kind of investment update including mortgage, loans, financial, etc. This relatable and understandable transparency won the bank a lot of respect. 

Similarly, hospitals, drug companies and insurance companies need to explain the actions behind their moves in order to drive goodwill. 

“Dig into how you can communicate. Not just for the sake of communicating but for a meaningful connection that helps the customer make the right decisions,” she said.

Third, companies need to be taking inventory on people’s reactions to pricing transparency. For example, do you have a pricing portal and are consumers using it? This commitment to collecting data shows your actions to help consumers make the right decisions. 

RELATED: Consumers skeptical of value-based insurance design, study finds

Along with the “pricing do's” are the “pricing don’ts,” Carter says.

First, don’t assume that the facts themselves will tell the story. While the facts are important, Carter says to start with the perspective of others and then bring the facts into the story. So, for example, when prices on premiums are increasing, there is a way to communicate that the company is doing everything it can to cut back in other areas and help its customers. 

Second, don’t demonize pharmaceutical companies, the government or providers. Most people that work in healthcare do so because they want to help others. So as soon as they are demonized for price or policy changes, these healthcare employees get defensive. 

Finally, think patient first and segmentation second. And while every industry has segmentation, it is not as defined for those shopping for healthcare. In general, Millennials and Baby Boomers all feel the same way on the issues, as they are all patients first, Carter says. 

“You have to understand what value is at play, this idea of fairness as a value. It comes down to fairness and justice,” Carter says. “Ultimately, let people know we are in this together.”

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