AllWays Insider

As the new year approaches, we’re increasingly excited about our transition to AllWays Health Partners, a plan that puts our customers’ needs at the center of everything we do.

Payment policies often seem different from payer to payer – which can add confusion to an already complex aspect of health care. However, the differences between the published payment policy and what a provider sees on an evidence of coverage often have nothing to do with the policy itself. The discrepancies are usually the result of variations in the member’s plan design, the provider’s contract, or both.

As part of our recent series on ASO health plans, Christine Murphy, Vice President of Network Management, talks about her experience in Silicon Valley during the dotcom boom of the 90s – and how health care companies can learn from Amazon.  

In the business-to-consumer space, why did Amazon become Amazon, while Pets.com became the poster child for dotcom failure? Because Amazon recognized that success was rooted in leveraging its technology platform, not in book selling. Similarly, health insurance providers and carriers who are transitioning from fully-insured /fee for service models to ASO/value based pricing models need to do more than provide service and process claims. They must join forces and leverage IT infrastructure intelligently to survive.

Imagine you’re shopping for soup and, at the store you’re in, the soup cans have no labels. It’s a whole aisle of identical, anonymous silver cans – all with different price tags. So you ask the clerk what’s in each can.

He tells you, “These soups are so unusual that we don’t have labels for them. To find out what’s in a can, you have to buy it.” “I have to know what’s inside before I decide it’s worth the price you’re asking,” you exclaim.
“Buy it! Then you can open it to find out what you bought!” the clerk says cheerfully. I’m guessing most people would leave this store without any soup.