Turbulent healthcare market demands new, innovative measures
As hospitals across the country take steps to make up for the significant financial impact of lost volumes resulting from the COVID-19 pandemic, Premise Health, the world’s leading direct health care provider, is leveraging its partnership with Healthcare Bluebook, an industry-leading price and quality transparency solution, to help its large employer clients connect their employees with high-quality, cost-effective care amid growing demand and cost.
The impact from COVID-19 has been felt by health care providers across the country, especially hospitals and health systems. Thirty-seven states canceled elective and non-emergent procedures and approximately 30 percent were postponed, leading 55 percent fewer Americans to seek hospital care in March and April. Although many of these procedures can be postponed temporarily, they cannot be postponed indefinitely, leaving sidelined consumers looking to reschedule their procedures as quickly as possible, regardless of cost, while hospitals are under pressure to make up for significant financial losses.
As a result of these losses, hospitals are likely to explore price increases for 2021 and may strive to capture additional volume and shift care to more profitable settings. According to an analysis from Strata Decision Technology, hospital revenues are down $60.1B per month since the start of the year, primarily because of decreased surgery volumes.
“We recognize many of our members and their families will need to see a specialist for care this summer or fall, and our work with clients and Healthcare Bluebook puts us in the perfect position to empower them to make the best, most affordable decision,” said Premise president Jami Doucette. “By being proactive and helping our clients stay ahead of these market changes, we can help them make the most of their health care spend and ensure their employees receive high quality specialty care at appropriate prices.”
According to Healthcare Bluebook data, cost and quality vary dramatically in the community, even for in-network care, and the choice of facility drives the greatest cost variability. The average in-network price variance for a given market is often upwards of 700 percent, and the lack of transparency across the industry makes it difficult for people to get access to high-value care on their own.
Premise’s Care Navigation solution leverages Healthcare Bluebook data to create a seamless solution for referring members to specialty care in their communities. To guide members to the in-network care with the greatest value, Premise utilizes its care navigators to match and refer them to high-quality providers with cost-effective facilities. The hands-on approach makes it easy to get the right care at the right price while delivering significant savings and high-value outcomes for employers.
“As COVID cases continue to rise in many parts of the country, we expect the backlog for specialty care to grow – putting additional pressure on hospitals to recapture lost volumes,” said Scott Paddock, CEO of Healthcare Bluebook. “When combined with the fact that many patients have delayed needed care and are now facing health conditions that will require more costly treatment, it’s clear that employers need a strategy to proactively manage health care costs. We’re proud to work with forward-thinking partners like Premise Health and their clients to empower employees with the information and tools needed to identify high-quality, high-value providers.”