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Prepare Your Organization for New Price Transparency Measures

As patients are starting to pay a greater share of their healthcare costs, they may expect more information to make informed decisions about quality and costs. Hospitals and healthcare systems can better meet consumer expectations by employing various medical price transparency strategies and will soon be required to provide more detailed pricing information online.

Under the final Center for Medicare & Medicaid Services (CMS) price transparency rule,1 beginning in 2021, healthcare organizations will be required to disclose standard charges for medical services, including payer-specific negotiated rates. Last week, the American Hospital Association’s challenge to this rule was rejected by a federal court.2 Despite the American Hospital Association’s plans to appeal this ruling, organizations (if they haven’t done so already) should adapt their price transparency processes to become compliant — as non-compliance has a maximum penalty of $300 per day per facility.

Your organization can be better positioned to meet price transparency rules — enhancing the patient financial experience, potentially improving patient satisfaction and optimizing collection efforts — with the following approaches:

Provide accurate, online price estimates 

Patients expect advance information on the costs associated with their care. According to our recent patient survey, nearly half (48%) of patients surveyed expect an upfront estimate of costs from their healthcare provider, especially younger generations (57% and 52% among Millennials and Gen Zers, respectively). Having an advanced, online patient estimation tool in place gives healthcare consumers the ability to view reliable estimates based off real-time insurance eligibility information and payer contracts. Allowing patients to view this information in a self-service manner helps empower them to be more engaged in their healthcare and aware of potential out-of-pocket costs.

Improve patient engagement efforts

Providing accurate estimates is only part of how you can create a better overall experience. Giving patients access to tailored payment options (based on their unique financial situation) not only helps them better control expenses, it can also help increase your collections. In fact, with the right tools in place, organizations have seen patient payment yield improve by 30–70%. Confirming your front end staff is equipped to communicate with patients via their preferred communications method (e.g., email, phone or mail) is also essential.

Consider weaving quality data into negotiated price rate information

Similar to other industries, consumers considering healthcare options often look at more than pricing information before making a decision. By displaying an organization’s payer-specific negotiated rates, the price transparency rule will likely drive competition within the industry.3 Presenting estimated costs of services, alongside information about the quality of said services, allows for better interpretation of data for more informed care decisions.

Consumerism and the need to provide cost transparency in healthcare is no longer a futuristic notion; it’s here to stay and healthcare organizations need to fully adopt it. Learn more about how TransUnion Healthcare’s suite of patient financial experience solutions can help your organization remain compliant with the new price transparency rules.

Sources:
1https://www.hhs.gov/sites/default/files/cms-1717-f2.pdf
2https://www.wsj.com/articles/trump-administration-price-transparency-rule-covering-hospitals-upheld-11592945973
3https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html

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