Hospitals Adopt a Retail Approach to Gain Patient-Customers

US hospitals must compete with retail clinics, standalone surgical centers, and walk-up medical facilities for customers, so their prices must be more transparent, accessible, and defensible.

US hospitals must compete with retail clinics, standalone surgical centers, and walk-up medical facilities for customers, so their prices must be more transparent, accessible, and defensible. In other words, health systems have to think more like retailers as they adjust their approaches to attracting and retaining consumers.

With Americans facing higher deductibles and other cost-sharing measures, consumers are shopping around with a more price-conscious approach, taking their business away from health systems and gravitating to standalone operations with advertised prices and services, according to an October 2016 PwC Health Research Institute report.

The report is based on interviews conducted and data shared during presentations at the HFMA Annual National Institute conference in June 2016, as well as consumer and industry surveys conducted by PwC and Health Research Institute. The report examined pricing across 3 states (New Hampshire, Oregon, and Colorado) for a number of common medical procedures, finding wide differences in charges and pricing.

Interviews suggest that healthcare executives surveyed are taking action to avoid losing volume for their services. Most said they have adopted strategies common to the retail industry, such as price quotes, simplified billing, consumer outreach, and money-back guarantee as ways to gain and maintain volume. Consumers who do shop around are finding that prices vary from medical center to medical center. With many patients now having high-deductible health plans, it is imperative that consumers know in advance of a procedure how much they will owe. Some hospitals are using online tools that allow individuals to receive estimates for different procedures.

The report sums up its findings as follows:

  1. Use pricing strategies to consider “bundled” services: Developing an all-inclusive bundled service offering for a hospital’s core service is one way for health systems to build volume. Successful bundling also may lead to better brand recognition for the hospital.
  2. Compare charges against the competition: A first key step is an independent market analysis that examines what other providers charge for medical services. Providers should then analyze the negotiated rates they have with insurers, and compare with those found in the competitive market. This will allow better positioning to reduce or rationalize gross charges.
  3. Assess total reimbursement impact. Health systems need to carefully evaluate what impact chargemaster revisions might have on other areas of reimbursement. For example, dramatic changes in pricing can affect how hospitals report costs to Medicare and can impact disproportionate share hospital payments. “Careful evaluation of any price reduction strategy is critical to ensuring hospitals preserve and even build revenue through their pricing strategies.”