How UnitedHealthcare is using price transparency within its fastest growing health plan

UnitedHealthcare's deductible-free and fastest growing commercial health plan, Surest, is saving money for employers and employees by offering a shoppable healthcare experience.

Becker's connected with Surest CEO Alison Richards to learn more about what's behind the plan's "game changing" success.

Question: UnitedHealthcare recently completed a rebranding of Surest. What was the strategy behind doing that?

Alison Richards: In 2022 we announced the new name Surest. This name is simple and straightforward, while conveying the idea of clarity, confidence and control our members have with our health plans. In short, we provide options for people to have power over the choices they make, to receive costs and care options upfront and prioritize care providers based on their needs. Obviously, we considered dozens and dozens of options, with this name resonating the most with consumers, employers and care providers.

Q: Surest is your fastest growing commercial health plan. What do you attribute this to?

AR: The growth of this plan is being driven largely based on the results we are achieving, which includes improved member satisfaction, increased access to preventive care and lower overall costs. Through this health plan, we are helping make healthcare more accessible and affordable for UnitedHealthcare members across the country. Key results include:    

Higher rates of preventive care:
By making it easier for people to understand and use their benefits, members in this plan had a 20% increase in physician visits and a 9% increase in preventive physical exams compared to people enrolled in traditional plans. That included a 15% improvement in preventive mammograms and a 34% higher rate of preventive colonoscopies for members. These types of preventive care can help identify potential health concerns earlier, which may contribute to better health outcomes and improved quality of life.

Lower healthcare costs: UnitedHealthcare members enrolled in this plan paid 54% less out of pocket, while employers reported an average savings of 11%. This is in part achieved by reducing inpatient hospital admissions by 13% and emergency room use by 6%, categories of care that are significant cost drivers for employers. At the same time, members of this plan more frequently access higher-value settings, including urgent care at a 6% higher rate and a 7X increase in virtual care visits.

Improved member satisfaction: For people enrolled in this plan, the Net Promoter Score – a key measure of consumer satisfaction – was significantly higher than industry benchmarks. Nine out of 10 members re-enroll in this health plan year over year, which demonstrates that the plan resonates with consumers.

Q: On the plan app, members can compare prices for healthcare services. Is that for in-network providers only? Should all UnitedHealthcare members shop around for the best healthcare prices now?

AR: Yes, UnitedHealthcare members enrolled in this plan are able to access cost and coverage information upfront for in-network healthcare providers and facilities. By displaying this information upfront, the plan is designed to help members select the right care, at the right time and in the right setting.

More broadly, UnitedHealthcare has been offering quality and cost information to millions of our members for many years, helping people comparison shop for care like other products and services. We know consumers overwhelmingly agree they want access to cost information, given a recent survey found that 94% of adults think hospitals, insurance companies and doctors should be required to disclose specific price information.  

Q: Surest will be offered to more than 4.4 million employees in 2024. How do you decide which customers to offer this plan to? How many are currently enrolled?

AR: The adoption of this plan depends on decisions made by specific employers. Hundreds of employers already offer this plan to their employees, including one in five of our national account customers for 2024. In terms of specific membership, our company does not break out enrollment at the individual plan level.

Q: Surest is saving employers an average of 11%. At the same time, the plan lowers out-of-pocket costs for employees by 54%, in addition to boosting health outcomes across several categories. Do you attribute this to the price transparency aspect of the plan?

AR: UnitedHealthcare’s Surest plan is designed to make it easier and more convenient for members to comparison shop for care in advance of treatment. Rather than often-confusing deductibles and co-insurance, the plan uses value-based copays. This means members often pay different amounts for the same service depending on the care provider and facility selected. 

An example can help illustrate how this plan works to help lower costs for members and employers. In Dallas, the price of knee replacements can range from $20,000 to $84,000. That’s a massive difference depending on which hospital is selected, but for members enrolled in a traditional plan with a $2,000 deductible and 20% coinsurance, that variation is largely irrelevant or confusing to understand.

As a member going to the more affordable hospital, I'd be responsible for that deductible of $2,000. I’d satisfy my coinsurance of $2,000, which would mean I would hit my out-of-pocket maximum of $4,000. While I’d pay $4,000, the health plan or employer would pay $16,000.

Now take this same example, but instead of going to the affordable option, the member opts for the more expensive hospital. The member would still pay the same amount, $4,000, but the health plan or employer would now be on the hook for over $80,000 – a 5X increase compared to if the member had opted for the more affordable care provider and facility.

This is why UnitedHealthcare’s Surest plan is a game changer. With the Surest plan in this example, the member copay would be $800 for the more affordable hospital, while the plan or employer would pay $19,200. For the more expensive hospital, the member’s copay would balloon to $2,600, while the health plan or employer would pay a whopping $81,400. By using upfront cost information and value-based copays, the Surest member is able to save almost $2,000 in out-of-pocket expenses by selecting the more affordable hospital. Meanwhile, the health plan or employer would save over $60,000. 

These types of situations play out every day for our members nationwide enrolled in this plan, helping to reduce costs and encourage access to quality care providers. We use our proprietary evaluation methodology together with massive UnitedHealthcare datasets to evaluate care provider performance, identifying professionals with higher signals of efficiency, quality, safety, and effectiveness in the care. These providers are generally assigned a lower copay, therefore encouraging members to select them.

Q: Is UnitedHealthcare considering rolling out similar “shopping” features across all commercial plans?

AR: UnitedHealthcare believes all people should have access to healthcare quality and cost information, helping consumers make more informed decisions and empowering them to comparison shop for health care like other products or services.

That’s why we have been advancing healthcare transparency for more than a decade, providing people with important information about healthcare quality and costs, including the ability to access personalized cost estimates based on actual contracted rates with healthcare providers and facilities.

Millions of UnitedHealthcare members have access to quality and cost information for more than 19,000 common medical services, with the ability to obtain this information online, via our mobile app and through our customer service advocates. The estimates are displayed as “episodes of care,” providing people a step-by-step view of what they should expect throughout the course of treatment.

Q: What does the success of Surest suggest about the direction the health insurance industry is moving?

AR: Based on our results, we know that consumerism works. If you give people a plan they can understand and feel comfortable using, coupled with information when they need it, they will make informed choices that benefit them – both from a health and financial perspective – and that benefit their employer too. We expect continued growth for this plan, as more employers and consumers recognize the value of this reimagined approach.

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