5 Ways To Practice Patient-Centered Price Transparency

To stay competitive amid healthcare “consumerization,” hospitals must do more than the minimum

If you think your hospital’s work is done when it comes to price transparency, think again. Posting your chargemaster online is enough to comply with the CMS mandate, but you’re not doing your patients any favors.

Reminder: According to the 2019 IPPS Final Rule, hospitals must post a machine-readable list of their charges online by January 1, 2019. The rule was intended to allow patients to look up and compare pricing information to make more informed decisions about where—and from whom—they receive care. It seems simple, but the added complexity of establishing and posting standard charges is a concern for hospitals that already face a multitude of regulatory requirements, notes Duane C. Abbey, in his AudioEducator webinar “Transparent and Proper Pricing for Hospitals in 2019.”

Standard Pricing Not Useful For Patients

To meet that mandate, many hospitals simply posted their chargemaster. The problem? Those charges aren’t all that transparent—they meet the rule’s requirements, but not its intent of moving towards what CMS calls a “patient-centered health system.” The numbers on your chargemaster may be machine-readable like the law requires, but those charges don’t mean much to patients. Unless they’re completely self-pay, the chargemaster doesn’t accurately reflect what patients will pay out-of-packet. Plus, the complexities of insurance assure that procedure prices vary from patient to patient.

Use Price Transparency To Increase Patient Satisfaction

In today’s healthcare market, patient satisfaction is quickly taking center stage. Not only does patient satisfaction affect your hospital’s ability to attract and retain patients, it affects clinical outcomes as well. Savvy hospital administrators know that patients have more options for care than ever before, and price transparency is a way for your hospital to stay competitive.

A list of standard hospital charges isn’t going to cut it. Even if you’re not ready to offer additional pricing information online alongside your chargemaster, there are several options for your hospital to practice patient-centered price transparency:

  • Remind patients that to accurately gauge pricing, they also need quality information. A low quality score could make a low-cost provider unappealing. This data is publicly available, so steer them towards the Physician Compare
  • If your hospital employs a financial counselor, encourage patients to discuss financial concerns with him or her. A financial counselor should be able to give more personalized pricing information based on the patient’s insurance plan.
  • Train staff—including physicians—to talk about prices, recommends the American Hospital Association. Patients may want to know why a procedure costs more at your hospital than it does at another.
  • Consider bundled pricing. Choosing one price that encompasses all services involved in a procedure—the episode of care—simplifies things for patients while encouraging cost control on the hospital’s part.
  • Learn from the retail industry. Some hospitals are decreasing prices of certain procedures to be competitive with others in their market—they are going “on sale.” Others have embraced online pricing tools where patients can log in and view a personalized pricing assessment—similar to online shopping.

Prepare For The CMS Price Transparency Rule

What can your hospital do to comply with the 2019 CMS price transparency ruling? Join Duane C. Abbey,  for his AudioEducator webinar “Transparent and Proper Pricing for Hospitals in 2019.” It’s especially important to understand the impact that APC and DRG has on your reimbursement, according to Abbey. In this webinar, Abbey discusses that and other price transparency factors including charge compression, cost-to-charge rations, pricing strategies, and more.

To join the conference or see a replay, order a DVD or transcript, or read more

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