Innovation meets insurance: 5 disruptive payers

By Dina Overland

Disrupter: Highmark

Disrupting: Price transparency

Details: Highmark launched its cost estimator tool in the spring of 2013, which allowed its members to obtain estimated out-of-pocket costs for certain medical procedures plus compare and rate doctors and medical facilities. "It just makes sense that we need to create a set of tools that people can use to understand and investigate the cost of care they receive," Matt Fidler, Highmark's vice president of consumerism and retail marketing, previously told FierceHealthPayer in an exclusive interview.

The Pittsburgh-based insurer aims to create a mind shift among healthcare consumers so they treat medical care like a car purchase. Just like someone wouldn't purchase a car without knowing how much it costs, Highmark wants to prevent consumers from buying a healthcare service without any knowledge of prices.

But Highmark doesn't provide a general idea of prices; its price transparency tool drills down costs based on the specific member's plan and how much they've already spent on deductibles. "The great thing is it doesn't just show me what the rack rate cost is for each procedure," Fidler explained. "It also pulls in my own product information, including whether I have met my deductible and coinsurance. So you're truly getting your own personalized rate."