Insurance News

Price Transparency to Become the Standard in American Healthcare

Price Transparency to Become the Standard in American Healthcare 1004 591 Apostrophe Health

With Apostrophe’s smart shopper, our members already enjoy the cost-saving benefits of price transparency without waiting on a new federal law.

Everything we do at Apostrophe is guided by simplicity, transparency, and love. We place the highest value on transparency, believing that every patient should know what they’re spending and what they’re saving.

That’s why we’re encouraged to see price transparency requirements issued by the Trump administration. Healthcare in America needs to be fixed, and this is a place to start that benefits every single patient. This historic effort aims to increase competition and lower costs for all Americans. 

The Health and Human Services Secretary Alex Azar says our current system deserves an F, but that after this takes effect, the president has promised an A+. This will be “a more significant change to American healthcare markets than any other single thing we’ve done, by shining light on the costs of our shadowy system and finally putting the American patient in control,” he said.

According to CMS, the executive order for Improving Price and Quality Transparency in American Healthcare outlines two rules designed to empower patients, and will take effect January 1, 2021. 

  • Price Transparency Requirements for Hospitals to Make Standard Charges Public, Final Rule

    All hospitals operating in the U.S. will “establish, update, and make public a list of their standard charges for items and services they provide.”

  • Transparency in Coverage, Proposed Rule

    Real-time access to cost information, including estimate of patients’ cost-share liability, through an online tool in order to shop and compare costs before care.

    It also requires that providers disclose, on a public website, the negotiated rates for 300 common, shoppable services (like x-rays, outpatient services, lab work, or bundled services like knee replacement or a c-section). This would include:
  • Full price before any discounts
  • Cash discounted price
  • Price negotiated with payers
  • The minimum/maximum with all payers

These disclosures are required under the ACA to some extent, but the data is hardly accessible, often too detailed and complicated. This new price transparency ruling aims to fix that by requiring accessibility and clarity by way of prominent publication and use of plain language.

This is what Apostrophe has offered its members all along through our smart shopper program. By selecting smart shopper options, which include high quality, low-cost providers, our members save enough money to result in $0 cost to them. We help them find the best possible rate from quality providers; it’s the difference between paying $2900 for a head CT, or $480 for the same service with the same (or better) results. We’re rewarding our members for making smart healthcare decisions.

That’s exactly what this price transparency ruling aims to do universally. This is a net-positive for employers who want to take control of healthcare costs (which, we imagine, is all of them!). For self-insured employers, this gives you power to help employees put published pricing information to work for both of you.

When price and quality data are available side by side, patients are more likely to opt for lower-cost care from highly-rated providers. In fact, they’re 94 percent more likely to choose the lower-priced option, according to SHRM. This can dramatically reduce healthcare costs for both employers and employees. Communicating the value of this information, and educating on how to use it, falls to the employers. 

Self-insured employers don’t have to wait for a transparency ruling to start saving their company and employees money, though. Contact us to learn more about Apostrophe.

Apostrophe, Inc., Secures $5.25 Million in Seed Funding

Apostrophe, Inc., Secures $5.25 Million in Seed Funding 2464 1500 Apostrophe Health

Health insurance industry challenger, Apostrophe, Inc., secures $5.25 million in seed funding included ULU Ventures, Northwest Venture Partners and others.

Healthcare Saving Platform Rewires How Money Flows Between Patients and Healthcare Providers, Cuts Costs for Employers

Apostrophe, Inc., a common sense healthcare savings platform for self-insured employers, has completed a $5.25 million seed round of financing. The investment round includes existing and new investors: Ulu VenturesNorwest Venture PartnersRoyal Street VenturesTechstars and Better Ventures. The financing will be used to support Apostrophe’s national market expansion.

Apostrophe replaces health plan administrators with a healthcare savings platform to give self-insured employers better benefits at lower costs. The company challenges today’s insurance marketplace with a new approach: putting member experience first, cutting waste and passing the savings on to its customers.

“Apostrophe is here to untangle the insanity of today’s healthcare services model with a common sense solution, and we’re grateful to our investors for supporting the Apostrophe mission,” says Apostrophe Chief Executive Officer and co-founder Cheryl Kellond. “Our customers save at least 20% on their healthcare costs in their first year, and their employees get benefits that actually feel like benefits. We’re providing a long-term solution that’s saving businesses money right now.”

Apostrophe creates savings by rewiring how the money flows between employers, providers, and members: the company pays healthcare providers upfront for services and negotiates lower rates for its customers.

To deliver better healthcare benefits in addition to significant savings, Apostrophe offers its members:

  • White Glove Concierge Service. A concierge team — available by phone, chat, email, and text — guides members to cost-effective quality healthcare
  • Full Access to All Care Providers. Members get local and virtual care options, including a curated suite of digital health services, with no “out of network” providers.
  •  Easy-to-Understand Bills. Apostrophe sends members single, unified bills to end billing confusion, with flexible repayment options.

“Healthcare benefits need digital optimization to increase efficiency and improve healthcare outcomes. Apostrophe’s SaaS platform meets this market demand,” says Miriam Rivera, Managing Director of ULU Ventures. “They’ve struck the right balance of combining the latest technology with superior service and cost savings.”

About Apostrophe, Inc.

Apostrophe is a common sense healthcare savings platform that delivers better healthcare benefits at lower costs to self-insured employers. Female-founded and guided by simplicity, transparency, and love, Apostrophe is radically rewiring healthcare by changing how the money flows between employers, providers and members. With first-class concierge service and a curated suite of digital solutions, Apostrophe delivers benefits that actually feel like benefits and savings of 20% or more in the first year for its customers.

Based in Denver, Colorado, Apostrophe is a certified B Corporation and a Techstars graduate. For more information, visit www.apostrophehealth.com.