HBI’s newly released 2019 Price Transparency Report seeks to help answer this question. It features two independent studies that show how organizations’ performance with price transparency is not yet where it should be. In one study, HBI examined the websites of 272 hospitals and found that approximately 49% are not fully compliant with CMS’ 2019 price transparency rule requiring hospitals to publicly post their standard charges and average charges per DRG. Of all the facility types examined—including academic, pediatric, critical access, large (≥$250 million in net patient revenue), and small (<$250 million in net patient revenue)—pediatric facilities were the least compliant, with only 20% in full compliance.
With the recent passing of CMS’ Final Rule ratifying most of its price transparency proposals, compliance is increasingly crucial. By 2021, hospitals’ public pricing information will need to include payer-specific negotiated rates and standard charges for 300 “shoppable services.” What’s more, CMS will begin to monitor and enforce compliance through monetary penalties. To avoid such ramifications, organizations need to evaluate their current level of compliance, in addition to how they will incorporate expanded pricing information onto their websites.
Of course, price transparency is not just about compliance.
Also featured in the report is a social listening study HBI conducted that analyzes comments posted by patients about their financial experience across a variety of social media platforms, such as Twitter. This found that 76% of patient sentiments around billing is negative, and common themes of patient frustration include feeling burdened by hospital bills and that their financial responsibility wasn’t properly explained. Without context, publicly posted standard charge lists only make matters more confusing for patients.
Luckily, these concerns are preventable through a strong, proactive price transparency strategy that needs to go beyond simply providing estimates. After all, an estimate is only as good as a patient’s ability to understand and act upon it. Furthermore, price transparency is only one aspect of a consumer-friendly experience. Patients want options in how they navigate the financial aspects of their care. All of this is to say that organizations need to rethink how they offer transparency, and the solution lies in a holistic approach.
HBI’s report provides a road map for getting there, examining the strategies and tools forward-thinking organizations are using to further price transparency. Here are just a few examples:
- Create estimates proactively for all services. Most organizations only provide estimates for certain scheduled services. Those at the forefront of transparency are expanding this to include all services, giving patients the ability to plan for their financial responsibility before care.
- Give patients the ability to generate their estimates. Having self-service estimation tools makes an organization stand out from their peers and provides a convenient way for patients to make more informed decisions about their care. The report includes an excerpt from one such price estimator used by an organization in Utah that allows patients to calculate custom, global estimates for over 450 procedures.
- Help patients navigate payment early on. The sooner staff communicate with patients about cost, payment options, and financial assistance, the better. Avoiding these conversations only delays financial concerns, while having them upfront helps patients plan for their responsibility proactively. In addition to providing educational tools and scripting, the report explores how one Midwestern organization is even working to educate physicians to have conversations with patients about price transparency.
- Offer lower-cost care alternatives. Providing telehealth services and arranging bundled payments with commercial payers are just two examples of lower-cost alternatives. This strategy addresses the heart of the issue: patients’ concern about out-of-pocket expenses. Healthcare costs are only rising, and with heightened visibility into pricing information, low-cost options may be especially attractive to patients.
Interested in learning how your organization can take price transparency to the next level? Members of HBI can access the full 2019 Price Transparency Report here.
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