The cost of healthcare has been a topic of heated debate in the US for many years. Variations in the price, efficiency and quality of clinical care are sometimes quite arbitrary, making it difficult for stakeholders in the healthcare ecosystem, including insurance carriers, brokers, and third-party administrators (TPAs), to provide meaningful recommendations to clients.
Hospital quality is vital for broker recommendations to clients because quality of care and patient safety both heavily impact the cost of care and ultimately the healthcare benefits packages. When the quality of care is excellent, brokers are better positioned to make sound recommendations about healthcare providers, and therefore gain credibility and trust.
Healthcare performance analytics, risk management and quality management solutions provider, Quantros, provides detailed medical analytics to help providers improve their quality of care, and help insurers or brokers improve the quality of their provider network.
“Insurance carriers and brokers can use healthcare performance analytics to converge the quality and cost of healthcare in a transparent way to plan sponsors, which enables the plan sponsors to get greater value out of the healthcare system,” said Shane Wolverton, senior vice president, corporate development, Quantros. “This idea is really starting to pick up momentum as insurers realize they can develop programs that will meet employers’ needs for lower cost and higher quality of healthcare.”
As employers and plan sponsors become more aware of the significant variations in quality and cost of healthcare providers, it has become equally important for insurance brokers to up their game. In order to succeed, traditional broker incentives like commission on the healthcare plan or placing of business, might need to change.
“Brokers have an opportunity to help employers navigate towards centers of excellence or higher value providers,” Wolverton told Insurance Business. “I would suggest any broker that has an interest in keeping their clients long-term should educate themselves around what quality of care and safety looks like. They should be thinking about how to measure it, how to communicate it with plan sponsors, and how to navigate the issues with carriers.
“Insurance brokers are starting to realize that what they’ve been delivering to clients is not necessarily a product where quality, efficiency and cost are all the same. They’re beginning to feel a fiduciary responsibility to help employers and plan sponsors navigate the healthcare landscape, either by working closely with carriers or by using transparency tools like ours to help employers find lower cost and higher quality providers.”