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The legislation would provide forgovernment reinsurance that would kick in only after privatecreditors had shouldered large losses. Heather, why is transparency such a top concern right now? Kawamoto Kawamoto: Department of Health and Human Services]. Or how do I stay as healthy as I can? Know before you owe Barnes-Lague Barnes-Lague: Patients now have a lot of skin in the game. And we get this information-rush from other parts of our lives. We have so much more information available to us when we buy groceries. If we do it online, we can compare and contrast, we can comparison shop, we can even get analysis brought to the table.
It can be a good thing. Julie, you are trying to help people make better paying decisions. If we have to live with more cost transparency, how can technology be a constructive part of it? Gerdeman Gerdeman: We have highly personalized experiences. And all of that should be the same in our healthcare experiences. This is what people have come to expect. So people are looking to understand upfront what they are going to owe.
Your provider should know that. Someone needs to inform me, and I want clouud now. They can instead book an appointment on their phone and go to the jnhibitors 20 minutes later. Fuve have the opportunity to pick where they get their care and they know it. So transparency can be clod force for good. It can help people make better decisions, be more efficient, and as a result drive their cost down. But transparency can put too much information in front of people, perhaps at a time when they are not really in a mindset to absorb it. What are you doing at CVS, Alena, to help people make better decisions, but not overload them? Clear information increases options Harrison: The key to good transparency tools is that they have to be a percent accurate.
Secondly, the information has to be clear, actionable, and relevant to the patient. If we gave patients 10 data points about the price of a drug — and sometimes there are 10 prices depending on how you look at it — it would overwhelm folks. It would confuse them, and we could lose that engagement.
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Providing simple, clear data that is accurate and actionable shows them the options specific to their benefit plan. That is what we can do to help consumers navigate through this very complex web in our healthcare system. Recondo helps people create and deliver estimates throughout this process. How does that help in providing the right information, at the right time, in the right context? Is there another location where the price might be different? What are my financial options in terms of the payment plan or some sort of assistance? They know they are going to be meeting with an orthopedic surgeon because they need knee arthroscopy.
In advance of that, they should be able to get some idea of what they are going to owe, relative to their specific benefit information. What are my options? I think that is critical.
And sometimes that hurts our volume. Well, would you rather trick them and then have bad debt? Perhaps they will come back for your MRI in December when their deductibles are met, and Toop can better afford it. Part of this solution requires the physician or practitioner to be educated enough to help the patient sort out the finances, as well as the care and medical treatments. As someone who has a lot of clinicians, technicians, and physicians, are they not the primary point for more transparency to the patient?
That would be the ideal solution, to have the physicians who are referring these very expensive services to begin having those conversations. Often patients are kind of robotic with what their doctors tell them.
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You have a choice to make some phone calls. You have a choice to do your own price shopping. So the new dual-major: Julie, your background is in technology. You and I both know there are lots of occupations where people have complex decisions to make. And they have to be provided trust and accommodation to make well-informed decisions.
Whether you are a purchasing agent, chief executive, or chief marketing officer, there are tools and data to help you. There have been great strides made in solving some of these problems. Is that what we are going to see applied to these medical decisions across the spectrum of payer, provider, and patient? Easy-to-access, secure data builds trust Gerdeman: This field is ripe for disruption. And technology, particularly platsic technology, can make a big difference in providing transparency. A lot of my colleagues here have talked about trust. Ifve me, the reason everybody is requiring transparency is to build trust. It goes back to that trusted relationship between the provider and the patient.
The inhubitors should ssurgery available to everyone. The consumer can make an informed decision, and the provider can know what the consumer is facing. Yet to work, that data needs to be protected. It needs to adhere to multiple regulations in multiple jurisdictions, and compliance is a moving target because the regulations change so often. Beth, what do we do to solve the data availability problem? Everybody knows data is how to solve it. But nobody wants to own and control that data. Sanborn Sanborn: How do you own all that data and protect it at the same time? We know that healthcare is one of the most attacked industries when it comes to cyber criminals, ransomware, and phishing.
I hear all the time from experts that as much as the human element drives healthcare, as far as data and its protection [the human element] is also the greatest vulnerability. Most of the attacks you hear about happen because someone clicked on a link in an email or left their laptop somewhere. These are basic human errors that can have catastrophic consequences depending on who is on the receiving end of that error. And so any developer, any innovator who is trying to help move this space forward has to make cybersecurity a grassroots foundational part of anything that they innovate. Alena, at CVS, do you see that data solution as a major hurdle to overcome?
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Meaning the controlling, managing, and protection of the data — but also making it available to plasticc nook and cranny that it needs to get to? To give a sense of what we are putting out there, the price transparency tools that we have developed are all directly connected to our claims system. They must reflect what that patient would pay as they go to their local pharmacy. So we have a lot going on with new transparency regulations, and more information coming out.
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We know that we have to make it secure, and we are going to have to overcome that. It seems to me, though, there are examples of the tools already developed and how they can be impactful; they can work. Joann at Shields, do you have any examples of what benefits can happen when you bring in the right tools for transparency and for making good decisions? Transparency upfront benefits bottom line Barnes-Lague: Yes, we bring in more revenue and we bring it in timely. Since we implemented tools, we are at 85 percent collected, a percent increase in our overall revenue. We are staffed around the automation now.
Julie, how does it work?