Industry talking heads have been crying wolf about the impact of employer rising healthcare costs for years. It seems that every year employers face a 5%+ increase in costs, prognosticators claim that this will be the year that more companies finally abandon their TPAs/ commercial plans or more fully adopt direct-to-provider or COE models.

And yet, the reality has been much more nuanced (as it often is). While the number of large employers going self-insured has barely budged in the past few years, we’ve seen only a gradual growth in other employer arrangements.

In the background, though, there's been one other trend: the steady growth of employer-focused “cost transparency” players. These companies (many now owned by payers) have entered the market with promises to disrupt the way that employees search for and access healthcare. Some do this through forcing patients to engage with data on provider quality/ outcomes, while others actually price patients’ out-of-pocket costs differently based on their contracted rates.

From the perspective of employers and their workers, these services are meeting a real need. According to a 2021 survey conducted by the Robert Wood Johnson Foundation, 70% of U.S. healthcare consumers say they’re unsure what a procedure will cost even after receiving treatment, and half say they’ve skipped or delayed care due to fears of unknown costs.