Price Transparency Turbo Booster – Are You Ready?

Nick McLaughlin

Regional Director of Ridiculously Nice Sales at Americollect

As the rule stands today, hospitals are required to provide patients with a list of their standard charges at the patient’s request. This nudge toward healthcare consumerism and price transparency opened the age of patient responsibility estimates, but has not achieved the level of “shopping” for lower cost healthcare services that CMS wanted to see. Enter the price transparency turbo booster – 2019 IPPS/LTCH PPS final rule. Starting January 1, 2019, all hospitals will be required to post that same list of standard charges on the Internet in a machine-readable format.

Patient Challenges According to the CMS FAQs regarding this issue, the requirement applies to all items and all services provided by the hospital. One of the biggest challenges regarding this issue is that the list is to be pulled from the retail chargemaster, which does not reflect the amounts hospitals are actually reimbursed for their services. The published prices will be even further from the amounts patients should expect to pay out of pocket. Hopefully this possible confusion about how much a service will actually cost patients won’t cause them to postpone care and allow health issues to get worse.

Potential Hospital Solutions I see more vendors each year offering patient responsibility estimates, and if that isn’t something that your hospital has decided to implement, now may well be the time. One of the best responses to someone calling in to complain about how high your prices that they found on the Internet would be, “Well, Nick, what is the service that you are looking for?” How much a service is going to cost them is far more important to them than arguing that your retail chargemaster prices seem higher than your neighboring hospitals’. Teaching your front line staff to have these conversations in a Ridiculously Nice way, in order to help patients get the information that they are truly looking for, will pay great dividends with patient loyalty in the future.

Are you ready?

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