Price Transparency Updates and Solutions

A source for critical information and solutions to ensure your health care organization is compliant and successful in 2021.

"Implementing price transparency solutions is about more than just adhering to state and federal regulations; it's about serving patients and giving them the tools and information needed to make educated health care choices."
-Kyle Sherseth, Vice President, Advisory Services at nThrive


Price Transparency Milestones Since January 2019:

  • Time is of the essence to meet 2021 transparency mandates

    07/07/2020

    Judge rules in favor of Health and Human Services (HHS) on price transparency mandates, leaving health care organizations with less than six months to comply.

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  • Government moves for summary judgement

    02/04/2020

    Government moves for summary judgement in disclosure of negotiated charges lawsuit.

  • Four major health care associations and three hospitals sue Department of Health and Human Services

    12/04/2019

    Four major health care associations and three hospitals sue the Department of Health and Human Services, claiming that disclosure of negotiated payor contract rates is unlawful. Lawsuit claims this information is traditionally considered proprietary and should therefore remain private.

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  • OPPS rule adopted

    11/15/2019

    OPPS rule adopted despite backlash of more than 1,400 comments from hospitals and health care organizations, leading to legal action.

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  • CMS releases 2020 hospital Outpatient Prospective Payment System (OPPS) proposed rule

    07/01/2019

    CMS releases 2020 hospital Outpatient Prospective Payment System (OPPS) proposed rule.

  • President Trump signs executive order on "Improving Price and Quality Transparency in American Healthcare to Put Patients First"

    06/24/2019

    President Trump signs executive order on "Improving Price and Quality Transparency in American Healthcare to Put Patients First," that outlines a more aggressive plan.

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  • Federal price transparency requirements issued

    01/01/2019

    Federal price transparency requirements issued, initially requiring hospitals to post their standard charges to the internet in machine-readable format and update at least annually.

Price Transparency Preparation

  • Risk Areas and P&P

    Identify areas of risk and opportunities to improve CDM structure

  • Strategic Pricing

    Ensure optimal price positioning in your respective market

  • CDM Compliance

    Ensure your CDM facilitates accurate, compliant billing

  • Website CDM

    Create machine-readable CDM with all Standard Charge data

  • Patient Estimation

    Provide Patients with online access to accurate estimates prior to service

nThrive provides tools and services to health care providers
that comply with regulations and promote patient satisfaction:

Payment Estimator Tool

Payment estimator tool for the hospital and payment estimator tool for the patient are two applications on a single platform that help both hospitals and patients to build estimates quickly and easily. CarePricer facilitates accurate estimates within 90% of a final bill for Patient Access Representatives. CarePricer Payment Estimator empowers patients to build their own estimates and find out what they'll owe your hospital. Read More

Patient Financial Clearance Center

Patient Financial Clearance Center expands your capabilities by adding to your team without having to hire staff. Read More

Contract Management Suite

Contract Management Suite, the foundation that drives accurate patient estimates. Read More

CDM (Charge Description Master)

CDM (Charge Description Master) that manages thousands of continually changing charge items and regulations that could adversely impact pricing, revenue, costs and credibility. Read More

CDM Compliance Review Audit

CDM Compliance Review Audit to identify gaps in your chargemaster, ensure compliance and deliver actionable feedback for targeted improvement. Read More

nThrive Webinar

Watch the Webinar Replay, "Staying Compliant with the New Price Transparency Final Ruling" Learn More

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