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 […]
Tag: Price Transparency
Hospitals Must Post Standard Charges by 2021
In a Final Rule released Friday, November 15th, CMS implemented the majority of its price transparency proposals but gave hospitals an extra year to comply. By January 1st, 2021, hospitals must: Post standard charges for all items and services, which include: Gross chargemaster prices Payer-specific negotiated rates (which must also be labeled by plan) Discounted […]
Federal Government Weighing Stronger Price Transparency Rules
The federal government’s next action to improve price transparency among providers may be requiring organizations to publicize the contracted prices they charge insurance companies for services. A request for comment on this idea and other price transparency initiatives was slipped into a proposal to prevent health information blocking released in February by the Office of […]
Pulse Check: Price Transparency
Now that the CMS has stated that prices for all items and procedures must be posted online, it is important to ensure patients understand what these prices mean to them. We’ve seen healthcare organizations be effective creating a financial assistance committee that can partner with the community to determine the most efficient way to communicate […]
Three Lessons You’ll Learn During HBI’s Price Transparency Roundtable
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 […]
Reimbursement & Regulations: Price Transparency, IMRT planning, E&M
By:
Andrew Minten JD
Date:
September 7, 2018
Category:
Custom Services
Filed under:
charges, CMS, E&M, IMRT, Medicare, OIG, OIG Work Plan, Price Transparency, Radiation Therapy, Reimbursement & Regulations
The CMS has made final their rule to require all hospitals to publish a list of standard charges in a machine-readable format online at least once a year. This requirement will be in place as of January 1, 2019, so it is important to get your organization moving. The CMS created this rule in order […]
Pulse Check: Improving Revenue Cycle Operations and Maintaining Patient Satisfaction – Common Pitfalls to Avoid (Part 2)
Date:
August 1, 2018
Category:
Custom Services
Last week I discussed two pitfalls we commonly see at hospitals that threaten patient satisfaction: confusing patient statements and delayed patient refunds. Continuing the focus on the patient financial experience, the list of pitfalls expands. Pitfall 3: Inconsistent point of service collections Time and again, HBI sees patient access staff fail to advise patients of […]
Reimbursement and Regulations: Value-Based Reimbursement, Price Transparency, and OIG Updates
By:
Andrew Minten JD
Date:
June 1, 2018
Category:
Custom Services
Filed under:
2019 IPPS, chargemaster, CMS, Humana, IPPS, noninvasive home ventilators, OIG, OIG Work Plan, outpatient cardiac and pulmonary rehabilitation services, Price Transparency, reimbursement, Reimbursement & Regulations, respiratory assist devices, value-based care, value-based reimbursement
Though the transition from fee-for-service to value-based care is dreadfully slow (which makes sense with how many factors there are to juggle), commercial payers have been stepping up to the plate. Aetna and United Healthcare have stated that more than 45% of their total annual medical spend is in value-based contracts. As a recent highlight, […]
Reimbursement & Regulations: Stand-Alone EDs, New RAC Topics, Medicare Overpayments, and Publishing Standard Charges
By:
Andrew Minten JD
Date:
May 4, 2018
Category:
Custom Services
Filed under:
charge description master, chargemaster, CMS, duplicate claims, group 3 support surfaces, hospital costs, hospital price transparency, hospital standard costs, implantable automatic defibrillators, Medicare, Medicare overpayments, MedPAC, Off Campus ED, off-campus hospital outpatient departments, OIG, percutaneous implantation of neurostimulator electrode arrays, Price Transparency, publishing standard charges, RAC, recovery audit program, reimbursement, Reimbursement & Regulations, Stand-Alone ED
Though it is only the initial move, the Medicare Payment Advisory Commission has voted unanimously to ask federal lawmakers to reduce reimbursement for some stand-alone emergency departments (EDs) by 30%. Off-campus stand-alone EDs that operate within six miles of an on-campus hospital ED are being targeted. Roughly 66% of these facilities are owned by hospitals. […]