With vaccines offering hope that we’ll put the COVID-19 pandemic behind us, Vistara is an attractive option post-pandemic for employers looking to reduce healthcare costs while keeping employees happy.
Vistara is the next generation of plans that use reference-based pricing. It can be used in place of a network or in combination with a network for providers such as physicians and specialists. With either option, much of the medical cost is reduced based on utilizing a Medicare plus reimbursement, which is typically well below what a carrier network may deliver. While that may sound similar to reference-based pricing, the differentiator is the integrated experience. Vistara’s pricing is at the center of a set of tools used to engage members and providers both pre-and post-service, helping to ensure they both get the most out of the benefits offered.
Members have access to HST Connect, which is a mobile app and website that empowers them to choose a provider based not just on cost, but also on quality and the provider’s Vistara “acceptance rate.” By using this tool, members can help avoid potential balance bills. This tool provides an integrated provider lookup that give members the ability to look up network providers.
Providers also are educated at key points during prior authorization to make sure they understand the plan and reimbursement. This provides them the potential to negotiate a mutually agreeable price before services are rendered. In those rare instances when the member receives a balance bill, Vistara’s Patient Advocacy Center works with the provider on the member’s behalf to eliminate or reduce the bill. This collaborative approach results in a 98% acceptance rate.*
In summary, Vistara is an attractive option post-pandemic, reducing the cost of care in a way that benefits both members and providers. The benefits of these plans are key for the post-COVID-19 world. To find out more, contact us.
*Based on historical results. Not a guaranteed provider acceptance.
