3 Steps to Patient-Friendly Price Transparency

By Rebecca Marsh, MBA, CPC, CHC Senior Vice President, Advisory Services and Kyle Sherseth, Senior Manager, Advisory Services | Posted: 10/11/2019

In a matter of weeks, CMS will release its Price Transparency regulations that stipulate how far hospitals and health care organizations must go to share their pricing with patient consumers. With more stringent regulations expected soon, this is a timely and complex topic to address now.

One, two, three

In the September issue of HFMA's Revenue Cycle Strategist Newsletter [Read the full article here], we offer three key steps that hospitals can take to provide transparent, easy-to-use pricing for patients with less burden on hospital colleagues:

  • Adopt patient bill estimation technology
  • Develop a workflow
  • Analyze resource costs

Bill estimation technology makes the process of comparing costs easier and is one of the most effective ways to create an optimal financial experience that builds patient satisfaction and accelerates cash flow associated with patient liabilities. Hospitals and health care organizations that are transparency-ready will offer online, self-serve technology so patients can generate estimates to determine their projected out of pocket costs.

An operational workflow with a formalized education and training program for colleagues facilitates clear and streamlined communication between all parties. This helps ensure that accurate and current payor contract information is used to create better estimates for patients.

It is imperative to develop pricing that is based on the cost of providing care. Hospitals must develop a chargemaster structure that reflects health care industry best practice standards and establish a defensible pricing strategy.

What to expect from CMS

How far will CMS go in requiring providers to share their pricing with patient consumers? The primary concern is the requirement that hospitals post their negotiated payor contract rates for all charges and provide consumer-friendly reimbursement details on 300 shoppable services. This is a big leap from simply posting the chargemaster in a machine-readable format, as was required on January 1, 2019. Regardless of the outcome, adopting these three steps will increase the rate of patient satisfaction, improve system processes, and help prepare for future price transparency regulations.

To learn more about nThrive technologies and services that can help your organization prepare for the future, contact nThrive at solutions@nthrive.com or call us at (678) 323-2500 to speak with an nThrive expert.