What if we could flip the script? What if health insurance functioned as a care-navigation and decision-making platform that helped employees get to their best health, efficiently and affordably? What if we gave people the information and tools to treat health care like any other consumer service we use on a daily basis?

Employers have the opportunity, today, to turn their health insurance benefit into a consumer marketplace where people can research their health concerns and find instant answers, where they can see and compare their treatment options in real time, and where prices are clear and aligned with quality and value.

And, even more important, employers can give their employees the power to flex their coverage throughout the year as their needs change. For plannable, non-emergent care, people can pay for coverage when they actually need it, not all year out of fear that they might.

This kind of personalized health plan can improve both health and financial wellness. Here's how.

Eliminate deductibles and coinsurance

Deductibles and coinsurance don't belong in health insurance for several reasons.

First, they discourage effective utilization of health care. When employees fear high costs and surprise billing, and when they know they can't afford to pay for out-of-pocket expenses, they often don't get the care they need. This care avoidance can lead to higher long-term health care costs for both employers and employees.

Second, the HIPAA requirement that "similarly situated individuals" be treated the same is generally interpreted to address classes or groups of employees, but not pay or salary levels. Deductibles, coinsurance, and high out-of-pocket maximums have a regressive impact on lower-paid employees. A health plan with a $1,200 deductible and a $6,000 OOP maximum – which is a relatively generous "benefit" — in a group that has some employees who make $40K a year and others who make $400K a year is a very regressive plan. Employees at the low end of the income distribution might not feel they have health insurance at all. And because they're trying to make ends meet, they might use their health coverage sparingly. That is not a benefit—and it doesn't promote health or financial wellness with any meaningful equity.

Do better than "price transparency" and estimates

In October, the Departments of Health and Human Services (HHS), Treasury, and Labor issued the "Transparency in Coverage Final Rule," requiring most group health plans and health insurers in the group and individual markets to disclose price and cost-sharing information to participants.

This rule is an important step for the industry. It includes two broad requirements for insurers: (1) to provide estimates of members' cost-sharing for services and (2) to disclose provider-specific pricing information. But challenges remain:

• The complexity created by deductibles and coinsurance often means a member's cost-sharing is only an estimate rather than the actual price they will pay.
• The provision to disclose negotiated rates is supposed to help members determine their costs, but those rates still require additional information to truly represent the whole picture, including what services are being performed, which practitioners will be involved, and which drugs and medical supplies will be used.
• Disclosure of negotiated rates does not protect members from other factors that result in higher costs or surprise billing, such as unbundled services by out of network providers.

How are regular people supposed to know these details of how the health care system operates? And why do we burden them with all of this unnecessary work?

Modern health insurance design can eliminate the process of calculating and translating costs by providing clear, upfront prices for bundles of services that reflect how people access care.

For example, a health plan can provide a single price for a procedure like a knee replacement, which includes the facility fees, practitioner fees, medications, and supplies.

Show value to empower employee choice

Health insurance should highlight quality and value so individuals can choose more effective, efficient paths to health. To make this possible, treatment options must reflect what evidence-based medicine says is effective. Quality indicators should reflect provider performance, such as complication or readmission rates. The insurance industry has this data.

When people know which treatments are effective, when they know which providers consistently deliver the best results, and when they see clear prices, they can and will make their best decisions. In fact, data shows that 80% of employees choose the most cost-effective treatment option when given the chance to do so.

Doing better for our employees

Employer-sponsored health insurance is a critical benefit with huge health and financial implications. What worked decades ago simply doesn't work anymore. It's time that employees are given a personalized health plan that helps them achieve both better health and financial wellness. It's possible today.

Tony Miller, Bind CEO, believes the health insurance industry should deliver a marketplace-like experience—one where consumers can see and compare costs in advance of seeking care to make informed treatment choices. He founded Bind on the belief that people should pay less for providers and treatments that have a greater potential to get or keep them well.

Read more:

• How employers can help employees make better health care decisions
• Health care engagement: Consumers continue to 'kick that can down the road'
• Indiana employer group's research shines a light on price transparency