Health Payer Introduces Price Shopping Tool to Drive Care Quality | Patient EngagementHIT

Previously, Blue Cross NC has offered patients access to price transparency tool Blue Connect, which allows patients to view cost estimates for various procedures. While all patients will still have access to Blue Connect, Blue Cross NC will begin rolling out the SmartShopper tool to patients covered by one of the payer’s large employer-sponsored healthcare plans.

Users can “shop” approximately 80 common medical procedures using the cost transparency information provide by Blue Connect and make their price and quality selection using SmartShopper. Once a patient chooses a reward-eligible location and the claim is fully paid, the patient will receive an payment for selecting a reportedly cost-efficient provider.

This program should have twofold financial benefits for patients, Blue Cross NC added. In addition to the reward checks, patients should theoretically see lower medical bills for lower-cost facilities.

This program aligns with what many in the industry are calling for – better price transparency and patient empowerment to select the healthcare services that are best for their care and financial needs. However, critics of the Blue Cross NC SmartShopper program state that the program incentivizes patients to select cheaper, and potentially lower-quality care for a relatively small financial payoff. This could impact long term patient health and healing.

But overall, the healthcare industry has embraced price transparency as a positive step toward patient empowerment and reducing growing healthcare costs. HHS has recently made it a key part of its strategy to reduce drug prices. And most studies agree that patients value price transparency tools, even if those tools are not yet prevalent or are confusing to use.

Going forward, more healthcare organizations are expected to take a similar approach to driving price transparency as Blue Cross NC has. Giving patients the tool necessary to understand the quality of care and the price of their care could help patients make better treatment decisions.

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Health Payer Introduces Price Shopping Tool to Drive Care Quality.