February 2016 – Member Site Treatment Cost Estimators

High deductible health care plans encourage patients to shop around for healthcare services. Healthcare services cost estimators are excellent online resources for members interested in learning about the cost and quality of services provided by their local practitioners. This Healthcare Monitor Report examines the healthcare services cost estimators provided on the member websites of nine of our coverage group health plans.Our assessment of the estimator’s accessibility focuses on where and how it is promoted on the member site. Our analysis of interface design included layout, types of inputs and result presentation. We look to see if the estimators are developed in-house or by third-parties, and highlight developer similarities and differences. When examining the results, we evaluate how the firms present the estimated costs, the member’s responsibility, the health plan’s responsibility and any further cost and services analysis. This report assesses any additional functions that help members make an informed decision. Finally, we note if value-added help features, such as video tutorials, are offered.

This report focuses on the following aspects of each organization’s quote tools:

  • Accessibility
  • Inputs and design
  • Results
  • Additional tool functions

Overall, health plans performed well in this report, with most scoring a B or higher. The highest ranked health plans provide the most information on the direct effect of costs on the member’s plan and the measures to select the best providers in terms of both quality and cost. High-ranked firms also offer noteworthy tools with extensive cost breakdowns and educational resources. Health plans that ranked the lowest lacked personalized cost details with accurate plan responsibility and member responsibility amounts.

All health plan member sites offer good accessibility and promotion of the treatment cost estimators. Cost estimators are only available behind the login of health plan member sites as they include the member’s plan into price estimates. Eighty-nine percent of the estimators are accessible from the member homepage. Main menu links (44%), quick links sections (44%) and universal footers (22%) improve tool accessibility. Sixty-seven percent of firms promote their tools on two or more access points on member sites.

With predictive search capabilities offered on 88% of cost estimator tools, members are able to find a service or treatment easily. Tools organize treatments and condition searches by service types (89%) and by alphabetical indices (44%).

Cost and quality details offered by the estimators are the most crucial information provided, yet they vary the most across the cost estimators. While all firms include the total cost of the service and member financial responsibility, not all firms include the amount for which the health plan is responsible. Only 33% of firms include information on how much of the member’s deductible will remain after the treatment, and only two display the member’s coinsurance amount remaining after the treatment.

While all cost estimators should be inherently intuitive, video tutorials help promote and inform members of the tool’s functionalities and offerings. Currently, 56% of the estimators feature a video tutorial, and 67% provide FAQs sections or pages that help answer questions related to search screens, results screens or general health insurance content.

Among the coverage group:

  • 33% offer cost information by treatment/service stages
  • 33% offer average cost of treatment in member’s area
  • 89% offer quality designations on specific providers or healthcare facilities
  • 44% include patient experience or satisfaction scores specific to the selected healthcare service
  • Only two firms provide a treatment timeframe
  • All tools feature sorting or filtering options