Do you know what your healthcare services should cost you? You’re supposed to.
Recent federal regulations, part of the broader No Surprises Act, require hospitals to display prices of health services on their websites. The move is intended to create patient autonomy and help support price comparison. But only
Healthcare guidance platform Amino aims to help create this autonomy through their Smart Match program, which first launched in 2017 and is now being updated to better serve consumers in the wake of new transparency regulations. By analyzing billions of insurance claims, Smart Match uses data to give its partners’ employees personalized recommendations and options for healthcare based on cost, quality and network.
“We have a strong foundation of using cost and quality inputs to identify recommended providers — aka Smart Matches — and the output of those models will get even more accurate as we acquire additional data,” says Scott Kiever, chief revenue officer of Amino. “We’re investing in additional quality metrics to ensure Smart Matches always balance cost and quality factors.”
Prior to new regulations around healthcare pricing transparency, hospitals were only required to disclose gross, non-discounted charges for their services, which are rarely the cost of what insurers or patients pay. But, Kiever says, the average worker is still left in the dark — and that can lead to detrimental financial decisions.
“You're still seeing hardship withdrawals out of retirement plans because of medical expenses like surprise billing or out of network charges,” Kiever says. “The lack of awareness of the new rule really falls on the healthcare system itself.”
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Employers can play a part in helping employees understand new transparency rules — and give them the tools to better understand their options.
“We're seeing the emergence of the idea of ‘power of the patient’ and the realization that you can shop for healthcare,” Kiever says. “The opportunity as all these compliance regulations come into play is to help the consumer understand that it is important to ask questions and seek information and find a means to understand what are the best options for them and their families.”
Step one, Kiever says, is to utilize solutions like the kind Amino is aiming to provide: digital tools that can help employees navigate the best options within their network of coverage. “Smart Match takes into consideration both cost and quality, based on what we can see inside the claims data that we’ve assembled,” Kiever says. “That’s a next generation solution.”
