As more price transparency data becomes available from hospitals and payers, developers are finding ways to make this data useful for providers and patients.
Turquoise Health, launched in 2020, develops price transparency software. Marcus Dorstel, vice president of operations at Turquoise, sat down with Becker's to talk about good faith estimate requirements and the state of price transparency in 2023.
The No Surprises Act, which took effect in 2022, requires providers to create a good faith estimate of charges for a patient. The provisions of the law expanded on Jan. 1, requiring co-providers and facilities to be included in good faith estimates.
The software developer launched a new good faith estimate tool in January, designed to simplify the process of combining estimates for multiple services from multiple providers.
"What we came to learn in talking to hospitals, from our perspective in the industry, is it's not as easy as just asking hospitals to create estimates and be able to service those to patients," Mr. Dorstel said. "There's a lot of existing systems and an unfair lack of transparency that results in it being very difficult."
The Instant GFE tool allows multiple providers to collaborate and comment on a document, while remaining HIPAA-compliant.
"For example, a hospital facility might invite a surgeon from a medical group to collaborate on this food faith estimate, then ultimately deliver it to the patient," Mr. Dorstel said.
Road ahead for price transparency
According to an October 2022 report from Turquoise Health, 78 percent of hospitals have posted some form of machine-readable files, and 55 percent had complete price transparency data.
Mr. Dorstel said this data can be valuable, even if it is not 100 percent compliant with price transparency laws yet.
"Our customers have found it very valuable to be looking at this hospital data," he said. "You want to bring these non-complete, non-compliant files up to standard, and for hospitals that haven't posted anything, you definitely want them to. I think that's where we're looking at the government to do a bit more enforcement."
Price transparency data is posted in machine-readable files, designed for researchers and third-party developers to access, but many are starting to build consumer-facing tools with this data.
"This data is starting to influence consumers in that way," Mr. Dorstel said. "There's a lot of data out there, especially from the payer side and the hospital side. I think what we're seeing is companies are still building out the tools that consumers will use to really make it useful to allow customers to shop around for services."