Catching The Transparency Wave: Four Steps To Improve Healthcare Price Transparency

The wave of interest at the state and federal levels to increase healthcare price transparency is growing more powerful. Consumers become more responsible for their healthcare costs with high deductible health plans. Government actors are pushing for hospital price transparency. Now is the time to develop and improve your abilities and capabilities to provide consumers with accurate price estimates.

The Wave

Identify high-volume services

A first step in catching the transparency wave is identifying the lower-price, higher-demand services. Patients are more likely to seek price information on these services since they are commonly delivered. State and federal governments also are targeting theses services as part of their price transparency plans. It’s also important to link cost data with other important information sources, such as relevant and publicly-reported quality and patient safety scores. This helps patients identify high-value services instead of just lower cost healthcare.

Med Money

Posting pricing information online

How healthcare systems publicize information will depend on state and federal regulations. California, Florida, Maryland and some others operate websites with hospital charge master and pricing information. The federal government is pursuing similar, but different rules on publicly posting prices for healthcare systems and drug companies.

Posting pricing information online may help you get ahead of the healthcare price transparency wave. Allowing access to hospital prices online also may be more convenient option for patients. As smartphone adoption rises and technology advances, patients are seeking cost information in the palm of their hands.

Med Bill

Bundled Pricing Strategy

Another way to catch the price transparency wave likely could include bundled pricing. When patients undergo a procedure at a hospital, they typically receive a series of services included in an episode of care. A total joint replacement, for example, can include pre-admission planning, surgery, post-acute care and complication management.

Care episodes can complicate prices estimates. Patients may seek pricing information for the surgery, but really want to know the total cost of care for the procedure. Hospitals and health systems that offer bundled pricing may be in a better position to service their patients and offer more accurate price estimates. All-inclusive bundled service offering is one way to build volume because it’s more like the traditional retail experience. A successful bundling strategy also may lead to better brand recognition.

Money Chart

Educate Staff on Patient Financial Responsibility

As consumers gain greater access to hospital prices, one of the more likely sources they’ll turn to for advice are healthcare providers and their staff. How prepared are you clinicians and staff to answer pricing questions from patients? Only 23 percent of providers in a recent survey said they always discuss patient financial responsibility with their patients prior to care delivery, while 36 percent admitted to never having the talk with their patients.

Provider inexperience with patient financial responsibility talks can wipe out many of your efforts to improve price transparency. Effective communications will be key to ensuring your patients understand pricing and their financial responsibility, especially since insurance coverage often affects how much a patient actually pays.

Docs

To accurately communicate pricing information, the American Hospital Association advises providers and staff to:

  • Emphasize that prices are estimates
  • Notify patients of cost changes that may occur based on a patient’s health or complications
  • Explain what is and is not included in the estimate (physician fees, lab costs, etc.)
  • Tell patients what other medical bills they may receive for the service

Online

Use and Offer Price Transparency Tools

Technology and software can support with price transparency. Some healthcare systems have developed more of a retail approach with tools that gather pricing information on outpatient services and links the data to information on financial planners for consumers to use before, during and after the services. These transparency tools also can help to decrease costs. Putting transparent, accurate pricing information into the hands of patients and providers can help health systems direct patients to lower-cost clinicians and alternatives within the health system’s network. Accurate pricing estimates also can increase point-of-service patient collections.

You Are Not Alone

Perhaps the good news is you are not the only one struggling to develop meaningful ways to inform consumers of their financial responsibility. A group of researchers recently found that only 21 percent of hospitals had the ability to provide a complete hospital price estimate for a primary hip replacement. That could be seen as an opportunity to differentiate your hospital or health system in the marketplace.

SURF’S UP!

The healthcare price transparency waves will continue to hit the healthcare beaches for years to come. Healthcare consumers are increasingly becoming more responsible for their healthcare costs with the continued growth of high deductible health plans. State and federal governments are starting to demand it. The industry leaders will take advantage of this opportunity and realign their healthcare systems with this new reality. Give us a call today to learn how we can help your organization manage and optimize price transparency.

Leave a Reply

Your email address will not be published. Required fields are marked *


seven + 2 =