An insurer bets on price transparency

The ideas and innovators shaping health care

Oct 12, 2023 View in browser   By Evan Peng, Carmen Paun, Daniel Payne and Erin Schumaker CHECKUP In UnitedHealthcare's Surest plan, you know the price in advance. | AFP via Getty Images Subscribers to UnitedHealthcare’s Surest plan are asked to do something unusual in health care: Shop around. The insurer says it’s catching on — Surest is the company’s fastest growing plan among its commercial offerings — and is saving customers’ money. How so? On the plan app, subscribers can compare prices for sick visits at a doctor’s office, in a retail clinic or online and even get a quote for procedures like thyroid surgery. The premium and co-pay are all they pay. There are no deductibles or co-insurance. In a new report, Surest said its customers had 20 percent more doctor visits and 9 percent more preventive physical exams compared with people on traditional plans. The preventive care has no co-pay, per Obamacare rules. Overall, Surest members’ out-of-pocket costs were less than half that of people enrolled in traditional plans. Employers reported an average savings of 11 percent, the company said. Really? Surest attributed the savings partly to reduced inpatient hospital admissions (13 percent lower than traditional plans) and emergency room use (6 percent lower), which are significant cost drivers. Even so: Subscribers seem to select caregivers more often for price than other factors. Surest members received fewer surgeries than people in traditional plans. Of the surgeries they underwent, more were performed in ambulatory surgical centers, which are more cost-efficient than hospitals. Surest members also accessed virtual care at seven times the rate of traditional plan users.   GO INSIDE THE CAPITOL DOME: From the outset, POLITICO has been your eyes and ears on Capitol Hill, providing the most thorough Congress coverage — from political characters and emerging leaders to leadership squabbles and policy nuggets during committee markups and hearings. We're stepping up our game to ensure you’re fully informed on every key detail inside the Capitol Dome, all day, every day. Start your day with Playbook AM, refuel at midday with our Playbook PM halftime report and enrich your evening discussions with Huddle. Plus, stay updated with real-time buzz all day through our brand new Inside Congress Live feature. Learn more and subscribe here.     WELCOME TO FUTURE PULSE Mt. Vernon, Va. | Shawn Zeller This is where we explore the ideas and innovators shaping health care. California has banned purple and pink Peeps because the marshmallow candies contains red dye No. 3. Studies have shown the dye causes cancer in lab rats. The new law, signed by Democratic Gov. Gavin Newsom, spares the more popular yellow Peeps, which do not contain the chemical. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Lauren Gardner talks with Alice Miranda Ollstein about the impact of Ohio's vote on whether to add abortion protections into the state constitution next month — and why anti-abortion groups are pinning their hopes on the Buckeye State. Listen to today’s Pulse Check podcast THE LAB How the brain lights up while playing a video game could provide insight into Parkinson's disease. | AFP via Getty Images Deep-brain stimulation is often a last-ditch treatment for people with Parkinson’s disease, which involves implanting electrodes to stimulate an area of the brain associated with the condition. Researchers, led by Vasileios Christopoulos at the University of California, Riverside, are trying to improve outcomes by asking patients to play a simple video game using a joystick to move a cursor on a computer screen toward target locations while undergoing the surgery. Why so? Researchers hope the study will allow them to see the effectiveness of deep-brain stimulation therapy in real time. They’ll then use the behavioral and neurological data collected to build a mathematical model of the brain, which they’ll use to test theories about brain function. Why it matters: Parkinson’s affects brain function associated with movement regulation, which causes slow movements and difficulty starting or stopping movements. Although Parkinson’s itself isn’t fatal, related complications can be. After Alzheimer’s, Parkinson’s is the second most common neurodegenerative disease, with nearly 90,000 people diagnosed a year in the U.S. And that number is increasing, with a doubling in prevalence over the last 25 years, particularly among patients younger than 50.   DOWNLOAD THE POLITICO APP: Stay in the know with the POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need. DOWNLOAD FOR iOS – DOWNLOAD FOR ANDROID.     WORLD VIEW Bill Gates' foundation sees promise in using AI to reduce maternal and child mortality. | AFP via Getty Images A mother in Lagos, Nigeria, worries about her child’s fever in the middle of the night and reaches out to a telehealth platform for advice. Using the woman’s dialect, an AI-powered chatbot called Kem responds to her question in accessible terms. The chatbot already exists as part of the telehealth platform mDoc, but its founder, Nneka Mobisson, wants to improve its accuracy and capacity to respond to queries from low-income women of reproductive age in Nigeria. Meeting of the minds: The Bill & Melinda Gates Foundation sees mDoc as a potential helper in the fight against maternal and child death in Nigeria and is providing $100,000 to help Mobisson hone the product. “It shows what the opportunity is for us to be able to dramatically transform the health care landscape of our continent,” Mobisson told reporters in Dakar, Senegal, where the Gates Foundation hosted its annual Grand Challenges conference this week. A larger campaign: The foundation said it’s investing $30 million to support a new artificial intelligence platform in Africa to help scale up projects such as Mobisson’s and others seeking to use AI to improve health, education or agriculture on the continent. Other projects the foundation finances include the development of AI tools for frontline health care workers in low-resource settings that could provide them with second opinions and make recommendations on how to prescribe antibiotics in Ghana. The $30 million in funding “is a step towards ensuring the benefits of AI are relevant, affordable, and accessible to everyone — particularly those in low- and middle-income countries — and that these critical tools are developed safely, ethically, and equitably,” the foundation said in a statement.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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