Unlocking the power of price transparency data
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Welcome. You're listening to McKinsey on Healthcare Podcast. If you're looking for insights into the issues that matter most in healthcare right now, you're in the right place. Explore wide-ranging conversations with leaders, changemakers, innovators, and professionals who are at the heart of healthcare today. My name is Gunjan Khanna. I'm a senior partner at McKinsey & Company, and I lead globally their healthcare private equity practice. Let's get started. Today, I have the pleasure of joining a dear friend and one of the leaders in healthcare, Amanda Eisel, who is the Chief Executive Officer of Zealous, a healthcare financial services platform providing integrated healthcare cost management and payment solutions that connect together insurers, providers, and consumers.
Amanda has over 20-plus years of experience really working at the intersection of healthcare and technology and having been involved in creating and scaling multiple platforms, of course, Zealous, but previously Waystar, and has also been an operating partner at Bain Capital prior to joining Zealous. Now, within Zealous, she's been instrumental in accelerating companies' growth across development and launch of industry-leading reference-based pricing systems to support employees, employers, and TPAs. In addition, A lot of innovation going on from healthcare analytics standpoint, translating provider rate disclosure data sets into digestible insights for the payers. And in addition, several acquisitions, including Sapphire Digital, to offer one-of-a-kind digital consumer price navigation platform.
So lots going on, Amanda, at your front, as I see what Zealous is up to. We wanted to get Amanda together with us today on the podcast to really talk about one of the areas that they've been doing a lot of work on, including specifically on price transparency. Amanda, thank you for joining us today.
Thanks for having me, Girjan. I'm super excited about having the conversation. Excellent.
So you've had an immense amount of experience in working in different forms on healthcare technology, lots of different problems going on in healthcare. Why pick up an area like price transparency?
You know, I think over... call it a decade view out, it is some of the regulation that has the most potential to change healthcare. And so we're super excited about being involved in it from the start. And I say start because it was really just a couple of years ago that the regulations got announced first for hospitals, health systems, the provider side, and then for the payer side around price transparency. I get really excited as you think about the world of consumer engagement. And as you think about how payers and providers can use this information to take cost and complexity out of the system, I think there's just a lot of opportunity for us to drive.
As I think about from an audience standpoint, for somebody who's not close to price transparency, what do you think is an impact?
Yeah, so let me drill down on the two areas a little bit more. Think about first this consumer empowerment side. What it allows is really for us to be able to shop for healthcare, just like we shop for pretty much everything else in our lives. So think about the notion of, okay, you need to go have your ACL repaired. It unlocks the ability for now for you before you get that care to go in and understand within your healthcare plan design, the cost of the procedure. And what we're really pushing to advance is not just what the raw data is, so not just a specific provider a specific code, but to roll all of that information into one. So to say, to go get this episode of care, here's what we estimate it will cost.
And then what we're also evolving is bringing in other data that is out there in the field. So quality information, because that's really what we need. Again, back to every other industry. Those are the two things that we need to be able to bring together to really advance the way consumers shop for healthcare. And then I think on the other side of it, it's the, you know, healthcare is notorious for being a black box on the rates that are negotiated between payers and providers.
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