Navigating the Murky Waters of Healthcare Decisions

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Making good health care decisions is something all of us struggle with. The question that matters most to healthcare consumers is simple: how do I get the best care possible?

Unfortunately, getting answers to this question is far from simple. While most people rely on their doctors and healthcare network for referrals, the internet revolution has seen consumers turning to review sites for healthcare research. This is problematic because reviews are subjective, and lack the data needed to support proper healthcare decisions. Everyone wants a better solution, but accessing physician performance data is difficult and interpreting it overwhelms even the most sophisticated consumers.

At the same time, employers struggling with rising benefit expenditures are looking for guidance on how to lower healthcare costs by helping their employees make better decisions. In Gallagher’s 2015 Annual Benefits Strategy & Benchmarking Survey, employers again ranked controlling healthcare costs as their top benefits management priority. Like consumers, employers want a better solution.

The Rise of Healthcare Transparency

In recent years, the industry has moved increasingly towards healthcare transparency. Solutions like Castlight began to provide integrated cost views to help “price compare” medical procedures in an attempt to mitigate cost. However, it quickly became clear that cost transparency is not enough.

Choosing any option without considering quality can result in poor outcomes that are far more costly than the initial procedure. A study on the Impact of Complications On Costs of Major Surgical Procedures published in The Annals of Surgery showed that a serious complication can cost nearly SIX times more than the procedure itself. In cases of surgeries, this amounts to hundreds of thousands of dollars in direct cost per incidence, not to mention the indirect cost in lost productivity.

Quality is the key to controlling costs, and at the end of the day, quality is far more important to employees. No one wants to risk their lives to save a few dollars.

Healthcare Transparency 2.0:  Next Frontier

To address the need for quality transparency, a number of organizations have introduced quality transparency tools in the form of rankings and scores for healthcare providers. One such tool is offered by MPIRICA, which offers hospital and physician scoring. MPIRICA can integrate pricing with quality, as well as optimize self insured healthcare networks based on quality.

By summarizing very complex medical information into a easy to understand format, employees can now choose providers based on objective quality instead of subjective experience, thereby minimizing the risks of complications and even death.  Employers can avoid cost by removing risk, which translates into significant savings – something everyone can get behind.

To learn more about MPIRICA and see a demo of our platform please contact Bob Piper at biz-dev@mpirica.com.