You have to shop around. That’s the name of the game in our new consumer driven healthcare model. Customers are comparing prices of medical services at different hospitals – before deciding where to go. For the providers and facilities, this means pricing needs to be transparent, easy-to-understand, and readily available, but how? Let’s explore the current consumer trends, methods hospitals are using to evaluate their transparency and how to achieve hospital pricing transparency.
With increased insurance coverage nationwide, and as high deductible health plans are becoming more prevalent due to the Affordable Care Act, many Americans are using health insurance that is unfamiliar to them. For this reason, deductibles, premium payments, and other insurance costs are an uncomfortable topic which is receiving more attention as Americans are watching what they spend.
Healthcare Consumers Seek Hospital Pricing Information
As much as 21% of consumers are now comparing healthcare costs before services, according to a report by Public Agenda. Concluded in the report is the fact that Americans are eager to find this information, but 68% of the people polled felt that hospitals do not provide enough medical service cost information. Many have no idea where to start or how to find this information.
Of the 2,010 Americans polled in the Public Agenda survey, 57% state that they would like to have this information before services are provided, and 43% stated if they had the information available, they would choose the less expensive option. In fact, most respondents, 71% feel that higher price does not mean better care. Will Friedman, president of Public Agenda, issued the following statement in reference to the poll:
Overall, these findings signal many people are considering price when they choose providers and may be receptive to efforts that enable them to do more effectively”
Hospitals Use ”Secret Shoppers” to Gauge Pricing Transparency
Recently, the Ohio Hospital Association, in an attempt to improve pricing transparency, used a ”secret shopper” exercise where they sent trained personnel to investigate and compare medical services charges in a number of hospitals. Mike Abrams, the Ohio Healthcare Association CEO stated that many of the secret shoppers:
got very good information, there were a lot of people surprised at how difficult it was to get pricing information.”
How To Achieve Hospital Pricing Transparency
HFMA President and CEO Joseph J. Fifer, FHFMA, CPA, encourages healthcare finance professionals to continue the push for price transparency. But how? The following is a list of recommendations for providers:
- Hospitals and healthcare providers need to reach out the public and provide education and reliable resources where consumers can find hospital pricing information.
- Even when there are options to pay less, some people will be inclined to stay with their current provider or facility, but the information should still be made available and easily accessible.
- Hospitals and other healthcare facilities must provide resources to staff that makes this information readily available and easy-to-understand.
- Providers and other policymakers need to educate the public to help individuals understand the variations of hospital prices in the healthcare industry.
Pricing Estimation Software
What steps does your hospital need to take to achieve transparent pricing policies and deliver reliable estimates? It doesn’t have to be difficult.
- Identifies current patient & insurance financial responsibility
- Evaluates contract pricing, procedure codes and allowable amounts
- Calculates charges from contract and historical hospital charge data
- Publishes price transparency data to hospital website
Price Estimation software makes it easy for patient access staff to give the patient a clear understanding of pricing, with estimates created for services that include all insurance, co-payments and patient responsibility clearly defined, down to specific physician bias.