How we create more affordable healthcare options for members

Affordable healthcare is one of the biggest issues millions of Americans face every day. At LifeWise, we understand our responsibility to make dollars work harder. Affordability sits at the heart of everything we do and all the decisions we make. 

One advantage to being a not-for-profit health plan provider is that we can—and do—reinvest every dollar into cost controls, care quality, and community support. 

How we spend premium dollars: 

Taking on high drug prices

Brand-name and specialty drugs top the list of high-priced medications. At LifeWise, we promote safe, lower-cost, and equally as effective alternatives such as generic and biosimilar drugs which often pencil out to savings as high as 40%.  

Boosting the workforce 

A workforce shortage in healthcare creates access and affordability challenges for patients. An aging population is putting further demand on an understaffed service. 

At LifeWise, we’ve invested $30 million in healthcare workforce expansion, with a focus on primary care in the state of Washington. Our partnerships with Kinwell primary care clinics in Washington go a long way in improving access to care for our members and will also serve to reduce the total cost of care. 

Opening access to timely care

The cost of care is the top reason why people postpone it. When that happens, outcomes worsen and treatment expenses rise. 

LifeWise plans include options for timely access to high-quality and low-cost care, such as convenient telehealth visits and short wait times at neighborhood Kinwell primary care clinics. Preventive care visits with an in-network provider are covered at no cost to members. Preventive care visits are very effective at catching issues early before they become difficult and expensive to treat.   

Cutting down on waste

Industry-wide, up to 25% of healthcare spending is lost to duplicative tests, low-value care, burdensome administrative tasks, and fraud. Our fight against these and other forces of waste is an ongoing effort. 

Artificial intelligence (AI) plays a role here too. At LifeWise, we’re exploring ways to safely and securely use AI to speed up administrative tasks, improve accuracy, and streamline processes that ultimately produce greater efficiencies and reduce waste. 

Rest assured, any use of AI at LifeWise will always be ethical and involve human oversight. Claim denials at LifeWise, for example, will never be dictated exclusively by AI. 

Promoting price transparency

At LifeWise, we support policies that promote price transparency. We’re of the firm belief that hospitals should be required to publish standard prices so that our members can see and compare costs before treatment begins. Price transparency helps members choose more affordable care options and eliminates surprise bills. 

Streamlining prior authorization requests

Timely care is essential for managing costs and achieving the best possible outcome. Policies that promote simplicity and speed for prior authorization requests are also initiatives we support. Helping patients get needed care sooner is good for everybody.