Between impending federal price transparency regulation, more patients tapping into digital health solutions and receiving services virtually, and patients' increasing desire for a clear view into their out-of-pocket costs, hospitals must adapt the patient financial experience to protect recurring revenue from existing patients and grow revenue by attracting new patients.
During a workshop at Becker's Healthcare Health IT + Revenue Cycle Management Virtual Event in July, panelists discussed guiding principles for prince transparency and how to provide the financial experience patients want. The front-end revenue cycle management company AccuReg sponsored the workshop.
Panelists were:
- Deborah Vancleave, vice president of revenue cycle management at Mosaic Life Care (St. Joseph, Mo.)
- Clint Jones, vice president of business development for AccuReg
Four takeaways:
1. A January deadline is looming for federal regulation that aims to increase price transparency. Under a final rule issued in November, hospitals are required to disclose rates they negotiate with insurers beginning in 2021. This would be required for 300 "shoppable services," 70 of which are mandated by CMS. Industry groups representing hospitals and health systems challenged the rule in a lawsuit against HHS. Hospitals lost that lawsuit in June but have appealed.
2. Price transparency requires a comprehensive approach, in which the cost of care is clear and readily accessible to patients, according to Mr. Jones. He said price transparency should also enable patients to make meaningful cost comparisons among providers before receiving care.
3. For patients, price transparency means understanding their out-of-pocket cost, according to Mrs. Vancleave. This includes ensuring patients know the price of the complete service, the medical benefit of the service, their deductibles and their copays. "Without answers to these questions, the patient won't have enough information to make a competitive decision," she said.
4. Today's healthcare consumers also want easily accessible digital technology when it comes to their healthcare financial experience, although many providers do not provide this successfully, according to panelists. To deliver on price transparency, they said hospitals must not only respond to federal regulations, but also provide patients with the ability to shop for services using easily accessible digital technology. This can be in the form of online data portals, price estimation software and online scheduling tools. Panelists also recommended improving patient satisfaction and reducing financial anxiety by starting the conversation about financial responsibility with patients earlier, which can increase the likelihood of full, timely payment for services AccuReg offers patient estimation and price transparency solutions that enable hospitals to meet government regulations by the January 2021 compliance deadline.