3. Please use the questions box on your webinar
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SPONSORED BY
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Moderator
Editorial Programs Manager
Modern Healthcare
Healthcare Costs Exposed - The
Push for Price Transparency
4. Welcome!
During todayâs discussion, feel free to submit
questions at any time by using the questions box
A follow-up e-mail will be sent to all attendees with
links to the presentation materials online
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SPONSORED BY
Lana Djordjevic
Senior Manager, Product
Development
Priority Health
Paul Knudtson
Director, Patient Access
Saint Luke's Health
System
Maureen Mustard
Director of Healthcare
Analytics
New Hampshire Insurance
Department
Jaclyn Schiff
Moderator
Modern Healthcare
Healthcare Costs Exposed - The
Push for Price Transparency
5. Please use the questions box on your webinar
dashboard to submit questions to our moderator
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SPONSORED BY
Maureen Mustard
Director of Healthcare Analytics
New Hampshire Insurance
Department
Healthcare Costs Exposed - The
Push for Price Transparency
6. Creation of a Claims Database
⢠2003 â Legislation created Comprehensive Healthcare
Information System (CHIS)
⢠ââŚthe data shall be available as a resource for insurers, employers, providers,
purchasers of health care, and state agencies to continuously review health care
utilization, expenditures, and performance in NH and to enhance the ability of NH
consumers and employers to make informed and cost-effective health care choices.â NH
RSA 420-G:11-a Development of a Comprehensive Health Care Information System.
⢠Reports were created using the claims data that showed rising
premiums and level utilization in the state.
⢠Legislators recognized a need for greater price transparency in
the state
7/13/2016 Page 6
7. The start of transparency
⢠Rules went into effect in 2005, state first received claims
data in 2006.
⢠Methodology was developed at the Insurance Department
to show cost estimates using a bundled approach within a
few months of receiving the data.
⢠A website was created to publish estimates for about 30
procedures in New Hampshire
7/13/2016 Page 7
8. NH Health Cost
⢠www.nhhealthcost.org website was originally launched in 2007
and revamped in 2016
7/13/2016 Page 8
9. Expanded Website
⢠Later in July, the website will have 100 cost estimates that include
â Outpatient tests and procedures
â Radiology
â Laboratory services
â Behavioral Health
â Office Visits
â Chiropractic Care
â Physical Therapy
â Sleep Studies
â Dental Services
⢠Quality of Care Measures from National Sources
7/13/2016 Page 9
10. Product Innovation
⢠As of April 2015, approximately 79% of small group and 43% of large group
fully-insured members in NH are in âsite-of-servicesâ benefit designs, which
include incentives to use lower-cost providers
http://www.nh.gov/insurance/reports/documents/2015_annual_report_cost_drivers.pdf
⢠Seeing the data through NH HealthCost helps insurance carriers better
understand market prices for health care services, encouraging competition.
7/13/2016 Page 10
11. Trend towards low cost providers
⢠Members covered by carriers that were not in low-cost
provider option plans also shift to lower-cost settings
7/13/2016 Page 11
12. Marketing Efforts
⢠NHID hopes to increase public awareness of the website
to further promote use of lower cost providers.
⢠Sharing the tool with providers in hopes that they share
cost information with their patients when referring them for
procedures
⢠Seeking input for consumers about savings and
experiences using the website
7/13/2016 Page 12
13. Thank You
Contact Information
New Hampshire Insurance Department
21 South Fruit Street, Suite #14
Concord, NH 03301
requests@ins.nh.gov
Phone: (603) 271-2261
Fax: (603) 271-1406
TTY/TDD: 1 (800) 735-2964
www.nh.gov/insurance
maureen.mustard@ins.nh.gov
www.nhhealthcost.org7/13/2016 Page 13
14. Please use the questions box on your webinar
dashboard to submit questions to our moderator
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SPONSORED BY
Lana Djordjevic
Senior Manager, Product
Development
Priority Health
Healthcare Costs Exposed - The
Push for Price Transparency
15. ⢠Why transparency?
⢠Priority Healthâs journey
⢠PriorityRewards
The score board
⢠Challenges and opportunities
16.
17.
18.
19.
20. Priority Healthâs journey
Summer 2013
Published actual
price ranges through
partnership with
Healthcare Bluebook
January 2015
Cost Estimator, member
specific out of pocket
cost
July 2015
PriorityRewards
29. The score board
⢠9% Member engagement
⢠Issued over $350,000 in member Rewards
⢠More than $3.5M in savings
30. Challenges and opportunities
⢠Consumer engagement
⢠Understanding member behavior and how they
shop for care
⢠The price/quality conundrum
⢠Quality vs. patient ratings
⢠Variations in billing practices
⢠Transparency to the greater population
31.
32. Please use the questions box on your webinar
dashboard to submit questions to our moderator
Now speaking
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SPONSORED BY
Paul Knudtson
Director, Patient Access
Saint Luke's Health System
Healthcare Costs Exposed - The
Push for Price Transparency
33. ⢠Fully integrated health system in metropolitan Kansas City
⢠10 hospitals, 1,200 physicians, 65 specialty services
⢠Locally owned, not-for-profit, faith-based for 130 years
⢠Reputation for innovation, quality and compassion
⢠World class cardiovascular disease outcomes research
⢠One of nationâs leading stroke reversal programs
⢠10,000+ employees
⢠Serving patients in 65 counties in Missouri and Kansas
Saint Lukeâs Health System
2
35. Pricing Transparency
⢠SLHS complies with all CMS, IRS and ACA regulations.
⢠SLHS received recognition from HFMA as an adopter of the
Patient Financial Communications Best Practices.
⢠For pricing transparency to be meaningful a personalized price
estimate is needed.
36. Why
⢠It is the right thing to do for our patients!
⢠Patients really donât understand their benefits.
⢠Too late by the time the patient receives their statement.
⢠Patient complaints that someone should have told them how much to expect.
37. Scheduled Patientâs
⢠SLHS performs approximately 40,000 price estimates annually.
⢠For patients with expected out of pocket responsibility.
⢠Exclude patients with a secondary.
⢠Exclude patients with Medicaid.
⢠Comments from patients when contacted about estimate responsibility.
⢠âThank you, I had no idea.â
⢠Lotâs of great feedback from patients that signed up for exchange plans.
⢠Patient Example.
⢠Patient with a $5,000 deductible and did not know her deductible was so high.
⢠Patient elected to postpone her procedure until she could save some money to cover her estimated
out of pocket costs on this elective procedure.
38. Price Shopper
⢠SLHS has a Customer Service team that will take calls, emails or letters
from patients requesting pricing information.
⢠A personalized price estimate is performed for each patient that contacts us
requesting an estimate.
⢠Website has information about how to contact the team, apply for
Financial Assistance and our pricing transparency policies.
39. Results
⢠Customer service score for the question, âMy insurance matters and
financial obligations were clearly explained.â
YearYearYearYear TopTopTopTop BoxBoxBoxBox PercentilePercentilePercentilePercentile
RankingRankingRankingRanking
2010 58.4% Not Available
2011 55.9% 73rd
2012 58.4% 79th
2013 57.2% 66th
2014 66.8% 99th
2015 70.8% 99th
41. Thank you for attending
Thanks also
to our
panelists
Expect a follow-up email within two weeks
with links to presentation materials and
information about how to offer feedback.
For more information about upcoming webinars,
please visit ModernHealthcare.com/webinars
WEBINAR SERIES
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SPONSORED BY
Healthcare Costs Exposed - The
Push for Price Transparency
Lana Djordjevic
Senior Manager, Product
Development
Priority Health
Paul Knudtson
Director, Patient Access
Saint Luke's Health System
Maureen Mustard
Director of Healthcare Analytics
New Hampshire Insurance
Department