A Tale of two markets: Transparency’s impact on consumer healthcare and enterprise healthcare

As I prepare to speak at the upcoming Second National Summit on Health Care Price, Cost and Quality Transparency, I am struck by how much progress has been made with healthcare transparency in just a few short years and its impact on consumers and on enterprises.

For the consumer healthcare market, I am heartened when I hear about new programs that offer individuals general insight into costs for medical services and empower patients to ask their providers new questions. These efforts are critical. Millions of Americans fund their own health benefits, purchased through individual plans and the new public health exchanges.

Consumer health transparency takes many forms, varying greatly in design, content, and depth, and receives sponsorship from across the U.S. healthcare ecosystem. Notable examples include the mycareINsight, recently launched by the Indiana Hospital Association; Guroo.com, funded by the Health Care Cost Institute; and Price Check, a crowd-sourced approach to deriving healthcare costs in California that is supported by public radio stations, among others.

The enterprise healthcare market requires a different approach to make a significant impact on the $620 billion spent annually by U.S. employers to provide health benefits for half of all Americans. For large companies, transparency is a means to an end, not the end goal. Transparency serves as a fundamental building block in creating a personalized, integrated healthcare management approach for employers to better understand and manage healthcare investments and for employees to make more informed medical decisions. At Castlight we combine cost, quality, and patient experience data with other types of information and apply sophisticated data science to derive industry- and employer-specific insights. Based on these insights, we recommend clear-cut actions an enterprise can take to tailor its healthcare investments to better align with business imperatives.

Just last week, industry research firm Constellation Research issued a report announcing a new software category called cloud-based EHM (for Enterprise Healthcare Management), recognizing the needs of large companies to address healthcare as a business affordability crisis. In the report, author R. “Ray” Wang examines the far-reaching benefits of enterprise healthcare platforms, which go well beyond cost management to include the ability to integrate diverse benefit programs offered by employers, support talent management initiatives, increase worker productivity, and improve employee health and wellness.

Certainly, more can be done to bring the benefits of transparency to both the consumer healthcare market and the enterprise healthcare market. The Catalyst for Payment Reform has published excellent studies and a national scorecard that documents the need for more and better data, and the rights to use that data. At Castlight, we’ll continue to be part of the national dialogue about these topics as we continue our work.

What do you think about the state of healthcare transparency in the United States?