A roadmap to price transparency success

nthrive healthcare price transparency solutions for compliance

Healthcare is experiencing a dramatic rise in consumerism, accelerated by recent price transparency regulations. We’re caring for a generation of consumers that are now accustomed to (and expect) healthcare solutions with convenience and straight-forward pricing. Providing transparent pricing information to your consumers early in their care journey can help your hospital or healthcare organization create a loyal patient base and deliver a better patient financial experience.

To meet these consumer demands – and comply with new regulatory requirements – healthcare providers will soon need to present uninsured and self-pay patients a “good faith estimate” of expected charges before delivering care – a benchmark most providers are not ready for.1

To remain compliant and competitive during the transition to transparent pricing, healthcare leaders must:

Consider compliance the starting point.

Failure to comply with healthcare price transparency regulations could not only cost your organization hefty penalty fines, but can also distance a significant portion of your patient base given that 85% of Americans believe price transparency should be a priority for lawmakers.2 Providers who are not compliant as of January 1, 2022, could face penalties of up to $10,000 for each regulation violation.

Once transparent pricing is well defined, your focus should shift to ensuring that your pricing is not only defensible, but competitive in the local market. This will help your hospital or healthcare organization drive not only patient loyalty and satisfaction, but new patients as well.

Compete on estimation accuracy.

Accurate estimates are critical in empowering consumers to make well-informed decisions on where they receive care. Estimate accuracy is also crucial to preventing surprise billing for patients. When patients dispute charges that are at least $400 more than outlined charges in the good faith estimate, accuracy prevails.

Invest in integrated options.

Your patient estimation tool should be an extension of your facility and provide an integration level that seamlessly flows into your organization’s brand and workflows. Price transparency must meet the needs of patient access staff to seamlessly share data with consumers, payors and other providers. Patient estimates and other price transparency solutions that embed into existing workflows will help frontline staff efficiently achieve their priority objectives. Fewer manual tasks will make for less frustrated staff.

Looking ahead, patients will have the information and knowledge they need to make more informed purchasing decisions. According to a TransUnion report, 49% of patients say having clear information on expected out-of-pocket costs before receiving treatment impacts their decision to use a healthcare provider. Additionally, 62% of patients say knowing their out-of-pocket expenses in advance impacts the likelihood of pursuing care.3 Educated consumers will be empowered to shop around for services and your organization will need to be top of mind.

Contact us today and see how nThrive can help position your healthcare organization for success in meeting these mandates and consumer demands. Our well-designed price transparency solutions deliver an average estimate accuracy between 90 – 98.9% and a positive ROI for 100% of user organizations.

1. Healthcare Financial Resources, “CMS Raises the Stakes on Price Transparency Compliance: Issues New Civil Monetary Penalties,” September 2021.
2. Healthcare Finance News, “Just 5.6% of Hospitals Are Compliant with Price Transparency Rule,” July 2021.
3. TransUnion, “News Reports about a Weakening Economy Impacting How Some Patients Seek Medical Treatment,” September 2019.


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