As health insurers continue their quest of achieving consumer engagement, many believe that offering price transparency tools is a key factor in achieving that goal. And UnitedHealth is taking those tools one step further by providing very specific cost estimates to their members. That means UnitedHealth members can get an extremely accurate price for total service cost, out-of-pocket expenses, co-payments and any outstanding deductibles.
To learn more about how UnitedHealth is leading the charge on price transparency, FierceHealthPayer spoke with Victoria "Tory" Bogatyrenko, UnitedHealth's national vice president for product, innovation and marketing (pictured right).
FierceHealthPayer: What is UnitedHealth's philosophy on consumer price transparency?
Victoria Bogatyrenko: There are so many aspects to price transparency--there's looking to understand total cost, individuals' out-of-pocket cost before they get care and make an informed choice in provider. And there's being able to do that through multiple channels, whether on the computer or a mobile phone. We provide consumers with access to price transparency before they seek care through our portal, myuhc.com, and our mobile app, Health4Me.
So our whole philosophy around price transparency is to provide consumers with a complete and accurate picture that's personalized to their specific situation. And we're making it easy for them to access, navigate and complete the job by putting the tools in their hands, whether they're at home or on the go.
The other thing that I would add is that on Health4Me, we recently launched the ability for any consumer to get a cost estimate. So we're publishing to the public, free of cost, market average prices. These aren't provider-specific costs, but we can give them a sense of how much any particular service is going to cost based on where they live and where they're seeking care.
It goes along with our broader philosophy that transparency is important especially given the greater share of expenses being born by the consumer based on their benefit design.
FHP: Can you describe the types of price transparency tools UnitedHealth currently offers?
Bogatyrenko: About two years ago, we launched a tool called myHealthcare Cost Estimator that replaced a legacy price transparency tool that we had in the market for about eight years. The myHealthcare Cost Estimator, which to date has delivered estimates valued at about $2.1 billion to our consumers and should exceed $3 billion by the end of the year. The tool contains cost estimates for about 520 services, providing consumers with the full picture for all costs related to a service. For example, outpatient surgery includes doctor visits before the surgery, lab tests, the actual procedure and follow-up care. There's also a host of educational materials available in the tool, including information about their deductibles, coinsurance and copayment.
Once consumers select a service that they're anticipating, the tool will share whether there are other treatment options to consider. For example, if they're searching for a cost estimate for back surgery, myHealthcare Cost Estimator will give them information about back surgery costs as well as costs for physical therapy and other alternate options. It will also give information about the procedure itself--what to expect, things to talk to the doctor about ahead of time, how to prepare and what to expect in terms of recovery.
It's meant to be more than just a simple pricing tool. It's meant to provide a whole host of information, explain benefits, give information about treatments, educate about the difference in quality and cost and maximize the benefits that they're paying for.
After consumers receive their service, that's when myClaimsManager continues to deliver a level of transparency. Consumers can go into the UnitedHealth portal through Health4Me and easily understand what their out-of-pocket costs are once the claim has been adjudicated, what they owe and why. MyClaimsManager also allows consumers to pay providers directly through the tool online. Later on this year, we'll also be able to make that online payment directly to providers through Health4Me.
FHP: Do these tools help drive consumers to high-quality doctors?
Bogatyrenko: When you get into the cost estimator itself, the tool presents consumers with quality information. We actually have a certified quality and efficiency evaluation program [certified by the National Committee on Quality and Assurance] across many physician specialties. What the tool will do is reflect which of those physicians have met our standards for quality and efficiency and lists them as Tier 1. There's an icon that identifies Tier 1 providers, and there's information embedded in the tool to explain what Tier 1 means.
Consumers can also get information about each doctor's education background, demographics and directions to office. We're looking now at the ability to include consumer experience measures into the tool. We're doing that because, frankly, consumes have told us that while the objective quality measures are important, once they've narrowed down their choices to one or two physicians, they want other people's experience with a particular doctor. We anticipate that will come online late this year or early next year.
FHP: Do you have any data on how many people are downloading and/or are using the Health4Me app?
Bogatyrenko: We expect this year to be at about 3 million consumer log-ins into Health4Me. Last year, we were at about 2.5 million log-ins. So that number continues to grow and obviously the downloads continue to grow. What we find is that there's a core group of individuals who tend to be, for lack of a better word, frequent or heavy users of the Health4Me app. Those who use it tend to come back again and again. We're studying the characteristics of that frequent user group so we can do a better job of not only meeting their needs but also promoting the tool.
FHP: How long did it take to develop this tool?
Bogatyrenko: We had a good base to work from because we had an existing tool. Our focus was on redesigning the experience to make it easy and simple to navigate and also provide a lot of extra content. We did reengineer the cost estimate process so that our estimates are precise to the contracted rate we have with that doctor. It took about nine months from beginning to end. We spent time iterating and sharing versions with our employer customers and individual consumers to get their feedback and make sure we were incorporating all of the information they were looking for. We are continuing to work with consumers and, later this year, the myHealthcare Cost Estimator will get a new design based on consumer feedback. So we're redesigning the entire experience to make it simpler and easier to move through.
FHP: What do you think is the benefit, given the time, effort and cost involved, for UnitedHealth to provide these free price transparency tools?
Bogatyrenko: We feel it's our responsibility, and consumers expect us as an insurance company to give them tools to better manage and understand their benefits so they can make informed choices. So the value to UnitedHealth is establishing stronger relationships with consumers to create more informed and loyal consumers.
FHP: What are the next steps for the myHealthcare Cost Estimator and Health4Me? Do you plan on analyzing any of the data from the tools?
Bogatyrenko: In terms of dollars saved, we're starting the savings analysis now. I have some data that's anecdotal in specific markets, but it's too premature to share. One data point I can share is that users of the tool are upwards of 9 percent more likely to see a premium-designated provider, who is a doctor meeting the UnitedHealth premium designation standard for high-quality and high-efficiency. When that happens, those consumers actually see a cost reduction, a savings of on average about 10 percent. So there will be a lot more to come as we look at specific markets and practices like radiology and physical therapy. We also are comparing costs between people who use the tool and people who don't.
[Editor's Note: This interview has been edited and condensed for clarity.]