Hospital prices have been coming under increased scrutiny amid rising patient consumerism and regulatory attention. Most recently, CMS issued a new regulation requiring providers to publicize standard charges online on January 1, 2019. In this climate of transparency, organizations’ strategies for informing patients of their care costs are more important than ever. Leaders from University of Utah Health and Ochsner Health System—two organizations with strong approaches in this area—will join HBI on October 30 at 1:00 p.m. EDT for a roundtable discussion on meeting price transparency demands. Here are three lessons you can expect to learn:
How to provide a meaningful price estimate. Many organizations provide patients with price quotes prior to service. Often, however, these quotes do not include professional fees, leaving patients with only a partial understanding of what they will owe. University of Utah Health has taken the next step of providing a holistic estimate for common services through an interactive self-service tool on its website. The tool is public, so both prospective and existing patients can enter information about their insurance and service and instantly receive a comprehensive quote.
How to increase automation within the estimation process. Providing price quotes can be a time-consuming, manual process, especially if organizations do not have a tool to help staff analyze historical claims data and contract rates. Some organizations that do have this software still rely on staff to deliver estimates to patients, whether through a phone call or at the point of service. In an era of self-service options, automated estimate delivery is the next frontier for organizations. Ochsner Health System is pioneering such a strategy by automatically sending estimates to patients’ portal accounts for certain services. The process is seamless. After a patient is scheduled, the estimate flows to their account without them needing to take any action or speak with a staff member.
How other organizations are posting standard charges online. CMS has remained vague regarding what it means by “standard charges,” leaving organizations to make their own interpretations. In the absence of clarification, providers are grappling with how to be in compliance, yet publicize meaningful information. There is no single approach, but HBI members who attend the roundtable can learn more about how their peers plan to respond to this rule.
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