
Consumer Data Transparency Is More Important Than Ever as the Battle Against COVID Rages On
On January 1, CMS implemented the Hospital Price Transparency final rule, but by July, it was clear that many hospitals were noncompliant. Even with a proposed rule for penalties, requirements still only fall on certain parts of the health care industry.
It’s well known among economists and health leaders alike that US health care spending remains incredibly high and continues to grow rapidly. Health care spending in the United States is
Even though healthcare is one of our most essential needs, the health industry’s pricing and patient expected contributions are often cloaked in secrecy. Rates
CMS implemented the
Outpatient surgery has taken on an increasingly important role in the context of the larger health system, particularly as the nation continues to battle the effects of COVID-19 on hospital intensive care unit (ICU) and staff capacity. While ambulatory surgery centers (ASCs) are currently exempt from the federal rule on price transparency, many states are implementing their own regulations for price transparency in these settings. For example,
The
For this data to benefit patients and providers, the pricing and payment “menu” must be upfront and accessible. Health care facilities need to try to replicate how costs for services are communicated in other businesses. For example, car repair services or home remodeling companies do a diagnostic and develop a game plan for service and provide a clear cost estimate to the customer before they start working. Of course, there may be factors that cause adjustments, but the upfront information is organized in a way that consumers can easily compare similar services across potential contractors.
Many surgical business offices do attempt to calculate and communicate patient responsibility in advance. This is challenging because the data sources are not readily available or always reliable. To achieve the high level of accuracy needed surgery centers should adopt technology to calculate and communicate costs while avoiding information overload that could lead to patient misunderstandings of which information is relevant. The benefits of the right technology include improved staff efficiency, shifting dollars from postcare to preservice, compliance with state and federal laws, improved patient and surgeon satisfaction, and helping to drive the healthcare cost trajectory down by fostering competition, which will ultimately benefit the surgery center. New pending regulatory requirements on
In the context of COVID-19, we can expect case-type assignments and resource allocations between hospitals and ASCs to be more fluid than we have seen before. Before federal requirements catch up, taking steps to track and make price information available in the ASC setting will only further boost the industry’s reputation, demonstrate regulatory compliance, and make it easy to participate in the greater national move towards consumer transparency.
Author Information
Scott Palmer, MBA, is senior vice president of Business Development of
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