Navigating the complicated world of health care

These days, it’s hard for patients and other health care consumers to know if they have access to the best doctor, facility, or medication for a specific situation, even if they have a “preferred network,” center of excellence, or a well-known pharmacy benefit manager. Patient satisfaction surveys and self-reports by physicians or facilities are subjective and provide only “nice to know” information— like bedside manner or convenience of hours or of the  scheduling system. But there’s also plenty they don’t tell you, like how well your knee will perform post treatment, for example. 

Without objective, third-party scores for health outcomes and clinical studies, it’s nearly impossible for a member to make an informed decision. Relying on word-of-mouth recommendations, patient satisfaction surveys, or provider self-reports may not always lead to the best outcomes. Even your health plan or network may not be as effective as you think it is, regardless of the carrier or design.

While having access to a wide network is beneficial, it’s not enough. Narrow or high-performing networks (HPN) or centers of excellence (COEs) only tell part of the story. So, how can employers assist members in receiving the right care from the right provider at the right time? The answer lies in providing members with easy and informative tools to navigate their choices within their network using unbiased and third-party data. And they must be easy and compelling to use.