Tired of your health share members being overcharged for care? Here's how to stop it for good

January 20, 2022
Josie Livengood

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Good health is important for everyone no matter what kind of health coverage they have (or don’t have). But for this blog, we’re going to focus on why it’s so important for members of health shares to practice good preventive health. Plus, how health shares can make that care accessible and affordable. So, why is it so important for members to practice preventive care? For starters, preventive care is usually much more affordable than complex or emergency care. The cost of a primary care visit and medication will almost always be more affordable than an ER visit or a major surgery. As a health cost sharing group, you likely already know this. So, how do you make sure your members are receiving preventive care? We have some ideas.

Bring healthcare consumerism into your offerings.

Since members in health shares are cash-pay patients, you should make it easy for members to shop for care and incentivize them to do so. That’s where healthcare consumerism comes in. Americans are good at shopping and have access to shop for just about everything except for healthcare. But healthcare consumerism, price transparency, and other movements are looking to change that. For health shares, it’s very easy to integrate healthcare consumerism into your plan. Incentivize your members to shop for affordable care by lowering their out-of-pocket cost when they choose a more affordable provider. Once the incentive is in place, make it easy for them to shop. One of the ways to do so is by giving members an easy way to digitally shop for healthcare services. Not only does shopping and comparing primary care physicians help your members find affordable care that fits their needs, but it also helps lower your sharing costs and improve member satisfaction. In fact, one study found that 57% of those surveyed believe it’s important for their health plan to have digital self-service features. Wouldn’t you like to improve member satisfaction by 57%? Fulfilling members’ desire for self-service features, like a way to digitally shop-and-compare preventive care, can improve your retention and satisfaction. Not only that, but companies that embrace digital innovations are 26% more profitable than their peers.

Offer easily accessible and affordable primary care options.

Direct primary care (DPC) is one of the most efficient care options if you want to make preventive care more accessible and affordable for members. With direct primary care, members pay a subscription fee (monthly or yearly) to see a primary care physician as often as they want. The DPC movement keeps patients healthier by reducing barriers to speaking with their primary care physician. Plus, the average monthly cost of a DPC membership is $93.26, which is a great value when you consider that this fee often covers not just unlimited visits but also:

  • Clinical or laboratory services
  • Consultative services
  • Care coordination
  • And comprehensive care management.

Health shares could make DPC even more affordable by covering a part of the DPC membership. And of course, lowering the cost for members increases the likelihood of members frequently visiting their DPC for care. More frequent preventive care visits mean a higher chance of members’ improving their health and catching medical issues earlier on before they become emergencies. This will ultimately save money in the long run. Another affordable and accessible preventive care option is to offer virtual primary care (VPC).  VPC is very convenient and can lead to better health outcomes. VPC takes the same approach as DPV, but it increases access to primary care for members who are in rural areas or can’t easily travel to visit their doctor. Busy schedules often keep people from receiving the care they need, but seeing a doctor from wherever you are makes it a lot easier to prioritize your health. Just remember, the key is to keep your members in communication with a primary care doctor as much as possible so they call them first, instead of heading to an expensive ER when it is unnecessary.

Final thoughts.

Health shares don’t have to feel overwhelmed by the question “how do we make preventive care more accessible and affordable for members?” The solutions to achieve this goal are quite simple. You don’t even have to use all of the strategies listed in this blog. Starting with just direct primary care and covering a part of the membership cost can make a big impact on your members’ health, finances, and your group’s sharing costs. Same with digital shopping tools for preventive care services. Implementing a third-party app to take care of this kind of search-and-compare tool can make a big difference in how much members’ spend on preventive care. It can also improve your member satisfaction and retention. You can’t go wrong with any of the tips listed in this blog.

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Download Your Guide to 2022's Healthcare Policy Changes

Discover the major changes happening that affect you, how to prepare, and even how to make the new rules work in your favor.

Download The Limited Benefit Plans’ Guide to Competing On More Than Price

Discover how to stand out based on unique offerings and high member satisfaction, and how to implement these strategies.

Download The Complete Guide to Implementing Price Transparency

Discover how to bring price transparency into your benefit offerings to increase member satisfaction, lower overall costs, stand out from competitors, and improve member retention.

Download Your Roadmap to Creating Engaged Healthcare Consumers

Discover the roadmap unique to your health plan type and start seeing higher member satisfaction, lower overall costs, and healthier members.

Download How to Leverage Ambulatory Surgical Centers for Lower Costs and Higher Satisfaction

Discover how TPAs, health cost sharing groups, and limited benefit medical plans can benefit from the use of ASCs.

Download the Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Lowering Member Costs

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download Healthcare Consumerism 101: A Playbook for Health Plans

Learn the best strategies and tips for retaining your members while keeping costs low.

Download Your Guide to the Transparency in Coverage Rule

Discover how the the new rule will affect TPAs and health plans and how you can start your journey to compliance.

Download Your Guide to Unique Benefit Offerings that Don't Break the Bank

Discover how to add value to your health offerings that delight clients and members but don’t cost a fortune.

Download the Complete Sedera Case Study

Discover what health plan members had to say about the value of patient advocacy in our survey.

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