Azar’s price transparency mandate in healthcare is looming – are you ready?

by admin 0 Comments

Azar’s mandate to empower consumers in healthcare is almost here. In less than six months it will be 2019 and CMS’ new rule will take effect. Of the ruling’s many provisions to help consumers, price transparency is one of them. CMS issued a press release last week outlining several provisions of Proposed Rule 2019, including its intention to put patients first and to “lay the foundation for a patient-driven healthcare system.”[1]

One of the ways CMS seeks to help consumers is a commitment to price transparency and price shopping. CMS is “seeking comment through a Request for Information asking whether providers and suppliers can and should be required to inform patients about charge and payment information for healthcare services and out-of-pocket costs, what data elements would be most useful to promote price shopping, and what other changes are needed to empower healthcare consumers.”[2]

States are also allowing people to fight back. Take Texas, for example. In April, A Texas Supreme Court decided “that uninsured patients suing hospitals can access records detailing how much insurance companies pay for similar procedures is likely to make it easier for uninsured Texans to negotiate under like circumstances.”[3]

At least nine hospitals have closed since January 1. Community hospitals, especially, are in jeopardy. Financial distress can hit any size hospital. But as patients have become the new payers because of high deductible health plans and increased out-of-pocket expenses, hospitals are facing precarious situations like never before. Because, quite frankly, many people simply cannot pay their medical bills. Especially when they are hit with surprises. Besides Medicare and Medicaid, patients are the biggest payer today. This puts hospital systems under fire from lower volumes and lower receipts. People delay medical procedures, or when they do have them, they can’t pay because they didn’t know what they would cost.

Providing true pricing transparency before services are rendered, helps not only consumers, but providers as well. Add to that a way for people to set up payment plans, and the hospital is much more likely to receive its money. When providers do right by the patients and publish true prices, they avoid issues of sticker shock and surprise billing. As a result, people know what the prices are. Not only do they go ahead and schedule the procedures, they pay for them.

The best way to ensure that you get your money is to have patients pay upfront. HealthQRS offers an easy way do this: from the consumer app as they are scheduling procedures, and also at the point-of-service with interactive scripts that registrars can use to help people understand their costs. With our system, you are in charge of setting up the business rules. You decide whether to offer discounts for upfront payments, you decide about charity eligibility, and any other rule that affects your bottom line. All of that is streamlined into your revenue cycle management system as well as your EHR system.

Compliance is not an option. With CMS Proposed Rule 2019, you’re going to have to comply. Why not make it work in your best interest?

Give consumers what they want: access to the real costs of healthcare. Give them a way to shop, schedule and pay for services from their phones. This is an opportunity to go beyond what the government is requiring. You can turn an edict into a positive for your market share. In addition, our solution will solve your bad debt issues because we help you collect upfront. Our solution can be used for large employers, payers, and even state governments to manage their Medicaid programs.

HealthQRS has already created the patient-friendly interface that provides the “Amazon” experience in healthcare and you can implement that solution immediately. We are a software-as-a-service (SaaS), so you have no capital investment, just a low monthly fee. We also have a smartphone application that consumers can use to access actual costs. Using our system instead of relying on the chargemaster will allow people to see actual costs and not suffer from sticker shock. You can use this to comply with the government’s requirements as well as market your services.

Our e-commerce medical marketplace platform is the perfect vertical application for integrated delivery networks. Our solution provides regulation compliance and serves as a marketing tool for your services. At the same time, we will solve your bad debt issues caused by not collecting from consumers, and many other benefits. HealthQRS can also enhance your existing portals and other patient engagement solutions. Our user-friendly app points them to your portals which will improve your meaningful use numbers and increase meaningful use funds.

Our medical marketplace allows consumers to connect to your hospital as well as lower-cost services such as telehealth services and clinics. Our technology enables people to connect to more cost-effective, consumer-oriented healthcare options. If consumers opt for an in person visit, we can even help them find a ride to an in person visit, whether via Uber, taxi cab, or public transportation, for example.

Don’t wait until you’re forced into compliance to adopt a consumer model. To survive, it’s time to move. Today. HealthQRS has a platform that allows you to publish an online retail market for your patients right now.

HealthQRS has over 15 years of experience developing healthcare retail experiences for people and our founders have over 50 combined years of e-commerce experience. We invite you to watch our user-friendly app video that you can use to win consumers. We also have a point-of-service solution video that may interest you. You can also check out our E-Commerce Medical Marketplace Flyer for more information. We invite you to contact us or schedule a demo right now to get a jumpstart on 2019.

### 

[1] CMS Press Release, “CMS Empowers Patients and Ensures Site-Neutral Payment in Proposed Rule,” Jul 25, 2018, https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-07-25.html

[2] CMS Press Release, “CMS Empowers Patients and Ensures Site-Neutral Payment in Proposed Rule,” Jul 25, 2018, https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-07-25.html

[3] Meg Bryant, “Some patients fight back against surprise medical bills,” HealthCareDive, July 25, 2018, https://www.healthcaredive.com/news/some-patients-fight-back-against-surprise-medical-bills/526576/

 

Leave a reply

Your email address will not be published.

You may use these HTML tags and attributes:

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>