Designing Healthcare Transparency that Works

Increased transparency is essential to improving the U.S. healthcare system, and we are encouraged to see the White House making it a priority. Given rampant cost discrepancies within the healthcare system, the push to create more visibility into price and quality has to be a movement in the right direction. However, the real challenge is ensuring that this information can be delivered to patients in a meaningful, accurate, and usable way. 

In 2008, Castlight invented cost transparency technology to support patient healthcare decision making. Through the past decade of helping millions of Americans navigate their healthcare, we’ve learned that fulfilling the promise of cost transparency is more complex than providing the ability to check the price tag. Delivering meaningful cost transparency requires taking four considerations into account: 

  • Healthcare prices are personal: Any price insights must integrate with a health plan’s negotiated rates, a patient’s plan design, and where they are in their deductible to give them an accurate picture of their total out-of-pocket costs. 
  • Cost is not the most powerful factor in shopping for care: Patients are often equally weighing quality, provider location, and personal preferences. 
  • No visit to the doctor exists in isolation: The healthcare ecosystem is vast, with a patient’s care extending beyond the purview of any single provider or facility. Information from across the entire healthcare journey must be collected and presented in a user-friendly, centralized location, such as a health plan portal or navigation platform.
  • We’re not accustomed to being healthcare consumers: Healthcare information needs to be available in a consumer-grade, intuitive experience. Data-driven recommendations should be tailored to each patient’s specific health needs and benefits, and presented in a simplified format that leads to easy, effortless decision making.  

So while unlocking data is certainly an essential component to transforming the patient experience, it is just that–a component. To truly empower consumers, we need to translate the data into consumer-level insights, and provide the tools needed to deliver those insights. 

A huge amount of tech innovation has made all of this possible, but the vast majority of Americans still don’t have access to a solution from their health plan or provider that delivers the consumer-friendly recommendations that enable informed decisions. As HHS and CMS deliberate how to implement the executive order and successfully deliver transparency that works, we urge them to consider not just access to the data, but how patients will realistically use and apply this data to their choices.