Health, Care, Cost

ContextValueClient

Where we started

We started this project with a simple prompt: improve members’ financial health literacy so that they better understand the system. To help the members obtain, process, and understand health information “that is analogous to service experiences with retirement investments, real estate and educational financing.”

In the U.S., very few people understand how their health insurance works, and even fewer are motivated to learn. In our research, we found that most people learn the hard way - through experience. This knowledge gap is counterproductive to health literacy, which is essential for consumers to understand the implications of their decisions and behaviors to their individual health, the health of family members, and their ability to finance both.

Why is this important?

Health insurance is a 185.5 billion dollar industry

In 2015, 77% said they were confused by their EOBs and bills

By 2024, ~$1 of every $5 will be spent on healthcare

Our Client

For our capstone project, we teamed with Highmark, a non-profit healthcare company headquartered in Pittsburgh, Pennsylvania. Highmark provides healthcare throughout Pennsylvania, West Virginia, Delaware, and parts of Ohio. As part of the Blue Cross Blue Shield Association, Highmark also has agreements with other insurance companies and provider networks outside the region, which gives members a greater ability to use their plans outside of the region.

Highmark is also the nation’s second largest Integrated Delivery and Financing System. As the owner of the Allegheny Health Network, Highmark is able to provide both care and insurance to its members. By combining both sides of the equation, an IDFS can set up its infrastructure to improve care, enhance efficiency, and reduce costs. This is a unique aspect of Highmark that our team was excited to capitalize upon in our work.

One Goal

By creating an effortless, care-focused system for its members, Highmark wants to remove the stress that is currently associated with interacting with health and insurance, so that people can live longer, healthier lives.

Three Layers

Highmark describes three main needs of their members that they want to embody. They recognize that these needs build on each other though, and that we have to build the foundation (need 1) before we can move higher.

Three Essentials

Highmark wants to focus on the important aspects of their coverage when interacting with their members, and make these aspects as clear as possible.

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Research Overview