No one likes surprises, and that includes patients. But when it comes to pricing transparency, healthcare has lagged behind other industries. As healthcare consumers shoulder an ever-increasing proportion of their healthcare costs, the demand for easy-to-understand pricing information is increasing. A 2017 survey by Public Agenda found that 50 percent of Americans have tried to find out before getting care how much they would have to pay out-of-pocket, not including copays, and how much their insurers would pay. That same survey found that a smaller number of Americans (20 percent) have also tried to compare prices across multiple providers before getting care.
Now more than ever, consumers are demanding price transparency. But it’s not enough to post standard charges online and call it a day, though that could soon be a requirement if a Centers for Medicare and Medicaid Services proposed rule goes into effect later this year.
"Posting gross charges is misleading and inflammatory," Joe Fifer, CEO of the Healthcare Financial Management Association (HFMA), told Modern Healthcare. "I'd rather CMS focus on actual payments hospitals receive and what patients are responsible for."
Here are four other ideas for building a pricing transparency program that is truly consumer friendly:
Make the prices easy to access and use: A link on your hospital’s home page is the best place for patients to start the process of getting a price estimate. Building a self-service online tool that patients can access 24/7 is ideal, but if that’s not in the budget, make sure a phone number where patients can call for a price estimate is prominently displayed.
Explain what the numbers mean: It’s not enough to spit out a dollar amount. The friendliest price transparency tool is easy to understand and needs to provide clear definitions of what costs mean and explain which data are being used to create the estimates. Must-define terms, according to HFMA, include “charge,” “cost,” “price” and “out-of-pocket payment.” It’s also important to include information about what’s not included in the price estimate, such as physician’s fees.
Make the information meaningful: Different payers, different care sites, unforeseen complications—these factors and others can cause wide variations in price estimates. Make your pricing estimates as consumer-specific as possible. You can’t anticipate complications, but you can emphasize that prices provided ahead of time are estimates and that costs could be different depending on a patient’s health or if complications occur, suggests the Price Transparency Toolkit from the American Hospital Association.
Market your price transparency program: Be proactive in sharing price transparency information with prospective patients. Build estimates into the front-end patient experience and promote your program within the community. Also educate clinical staff about the program, ensuring they know where to direct patients for pricing estimates.