Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Private Payers News

How Healthcare Price Transparency Could Gain Consumer Loyalty

A new survey finds that consumers are seeking more price transparency and financial information from their health plans.

By Vera Gruessner

The lack of price transparency remains a major concern of consumers that healthcare payers will need to address in the coming years. A HealthEdge survey shows that 88 percent of polled consumers are looking for better price transparency from their health plans especially with regard to copays and deductibles.

Health Information Technology

The survey showed that consumers have low satisfaction when it comes to customer service and communication strategies among their health plans. Such low satisfaction could be a major problem, as consumers could choose a competing health insurance company during the next open enrollment season if they’re dissatisfied, said HealthEdge CEO Steve Krupa.

“Poor member service has a significant impact on a health plan’s bottom line, where a bad experience could very well mean a lost customer,” Krupa told “As our data shows, improving a health plan’s customer service representative’s ability to effectively research and answer simple member questions in a timely manner, or enabling a member to have accurate and user-friendly self-service options to seek answers to questions will have an immense impact on wasteful costs in the system.”

“As a result, health plans are at a critical juncture, where they must improve upon their ability to communicate with members to increase satisfaction and remain viable in this era where their members have the ability to ‘shop’ for coverage,” Krupa explained.

One way that healthcare payers could improve communication channels, price transparency, and customer service is by implementing innovative technologies including self-service tools and real-time access to patient data, according to Krupa.

READ MORE: Cost Shifting to Consumers May Reduce Patient Satisfaction

“The backbone of improving communication is the technology used to run a health plan’s business – it must enable them to them to effectively understand, segment, market to and service their member population, regardless of whether they are sick or healthy,” Krupa continued. “This transformation begins internally, with customer service representatives having clear, technology-driven means to answer straightforward member questions quickly and easily, without the need for multiple calls or further research.”

“It extends all the way to the consumer having self-service options to understand everything from where they stand in a smoking cessation or wellness program to an accurate, real-time understanding of their financial responsibility related to a particular claim.”

Ryan Rossier, Vice President of Platform Solutions at Medullan, told how turning quantitative member data into a narrative could help improve conversation between customer service representatives and policyholders.

“I would say that we - the collective we in healthcare - are still catching up to what folks are already doing [in other industries] from a technology perspective. From a contextual awareness perspective, with customer service being one of the key channels, it is as simple as ensuring that profile information is shared across departments,” Rossier mentioned. “An innovative example is something that we’ve been looking at a lot and it’s a technology that takes quantitative data of an individual - let’s say claims information and lab information - and turns the quantitative data into a narrative.”

The HealthEdge survey showed that consumers were more likely to rely on family and friends instead of their health plans when in need of healthcare advice. However, by incorporating new technologies and improving communication along with price transparency, health payers can gain the trust and support of their customer base.

READ MORE: Communication, Cost Transparency Impact Patient Engagement

“High customer satisfaction results in increased member loyalty and trust, and our survey shows that health plans have an enormous opportunity to cement themselves as trusted advisors with their members via effective communication,” Krupa said. “Today’s members primarily seek health-related information and advice from providers, friends and family and online websites sites; to-date, health insurers have not earned this trusted status due to such poor communication and a challenging user experience across many channels.”

“If health insurers can provide timely and relevant information on both programs and incentives to participate in on behalf of healthy behaviors, members will enjoy improved health, and will consume less healthcare resources. This will result in a better quality of life for the member and reduced resource usage paid for by the health insurer,” stated Krupa.

The survey also found that young adults are not receiving enough incentives from their health payers to pursue health and wellness targets. Health plans will need to begin incorporating incentives for healthy behaviors in order to gain loyalty from this particular member population.

“Finally, our research has uncovered underlying causes for Millennials to be dissatisfied with their health plans, regardless of what kind of health insurance they have. It shows that shows that incentives aren’t just for the sick or non-compliant – despite the perception that the Millennials see themselves as ‘invincible,’ they very much want incentives for healthy behaviors from their health insurers (more than any other age group we surveyed), and by and large, they aren’t getting them,” Krupa continued.

“Millennials also report the highest levels of frustration regarding communication with their health plan, and as a result, turn to other trusted sources (physicians, friends and family) for information about their benefits. Millennials are a finicky, discerning group that wields great influence and buying power – and will quickly and easily seek out information and services elsewhere after a poor experience,” he concluded.

READ MORE: Affordability, Cost Transparency Key for Patient Satisfaction


Dig Deeper:

Why Payers Should Consider Consumer Needs in Value-Based Care

Consumer Satisfaction Dips When Payers Lack Price Transparency


Sign up for our free newsletter:

Our privacy policy

no, thanks