As the number of patients shopping for health coverage independently is expected to increase to 52 million by 2020, so has grown the demand for greater transparency in healthcare. More than ever before, patients today are turning to mobile apps, reading online reviews, and checking physician rankings for specific procedures before making any purchase decisions.
One of the reasons that consumers have been demanding greater transparency is perhaps due to the prevalence of high-deductible insurance plans. Kaiser Family Foundation found that average out-of-pocket costs for the insured have increased by nearly 230% within the last 10 years.The good news for patients is that their cries are not going unheard, as some hospitals have responded by offering cost estimator tools.
"We know that patients [who] are more engaged in their care feel more empowered, have better clinical outcomes, and cost less." Mission Health CEO Ron Paulus, MD
The Center for Healthcare Transparency estimates that healthcare cost and quality level information will be accessible to 50% of U.S. citizens by 2020, and some consumer healthcare companies such as Amino are already taking strides towards this goal.
Amino provides a tool that offers patients customized price estimates for healthcare services over a network that includes 129 insurance companies and over 500,000 providers. Consumers can first search by region using an interactive map, then add more personal filters such as their insurance company, procedure type, or the level of experience of a particular doctor. At the end of the search, the goal is for patients to feel confident enough in the financial and quality aspects of the provider to book an online appointment through the portal.
Accuracy of Amino cost predictions
Users of the Amino cost estimator should feel assured that they are getting the most relevant data available, as their large insurance claims database consists of over 60 million cost estimates. By checking through historical claims submitted by providers between June 2015 and April 2016, the innovative company was able to create an advanced database that provides cost estimates by episodes of care - common services that a patient might receive while being treated for a particular ailment. This sophisticated methodology has allowed the company to provide more accurate cost estimates on providers, out-of-pocket costs, overall network rates.
In addition to the improved patient outcomes associated with healthcare transparency, benefits can also be seen in the area of provider quality management.
“It’s clear that greater availability of data on providers can not only help consumers make better choices, but also foster accountability among providers. Amino's data-driven approach to health care transparency, and in particular its examination into the quality and costs of care, shows promise as a way to reveal high value care for consumers and providers alike," said Ashish Jha, Professor at Harvard School of Public Health, in an Amino press release.
As its one-year anniversary draws close, Amino is proud of the impact it has had on healthcare transparency thus far but still recognizes opportunities for improvement. The company notes that there is not enough always enough data available on a provider to give a detailed analysis, which limits the personalization and accuracy of the cost-estimate. In some instances, a median price has to be used as a point of reference. Also, not all episodes of care are as cut and dry as the models used within the estimator tool, which causes variance in what the total out-of-pocket costs may be.
In a press release, executives noted plans to increase the number of healthcare cost estimates, encourage more feedback from patients and industry professionals, and source new data points.