How to turn CMS’ final rule on price transparency into a marketing opportunity

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January 1 is just weeks away. As you prepare to publish prices, we suggest there is more at stake for you than compliance. If you are planning to publish the charge master, remember two words: sticker shock. When people see charge master prices you may lose them to your competition. And your competition is more than another hospital. You are competing with retail clinics, telemedicine and people simply foregoing services because they either can’t afford the out-of-pocket or they are afraid to seek care because they can’t get a straight answer on how much it will cost them.

If you aren’t ready for Jan. 1, you aren’t alone. Becker’s Hospital Review recently published results of a survey by a provider of revenue cycle software and services that reveals the extent of healthcare providers’ concerns and lack of readiness for CMS’ price transparency final rule. Of the 150 providers who participated in the study: [1]

  • 92% are “somewhat” or “very” concerned about how their standard charges will be perceived by the public
  • 43% “don’t know yet” how they will address the mandate
  • 29% will post standard charges as well as other pricing information
  • 22% will only post standard charges
  • 26% are “very confident” they will meet the CMS price transparency mandate by Jan. 1
  • 66% are “somewhat confident”

If you’re drowning in financial woes from low volumes and revenues, and now faced with publishing prices to comply with CMS’ final rule, HealthQRS can help. We can turn the tide in your favor by winning over the savvy consumers who expect to shop for healthcare like they shop with Amazon. We can help you provide consumers with a true retail experience that shows them true pricing of your services will serve you well because that is a powerful marketing tool. And by doing so, you’ll be compliant with the price transparency rule. HealthQRS allows you to publish actual prices in a machine-readable format. Our solution gives people a site that allows them to use their smartphones, tablets or PCs to shop for services and medications and see actual pricing and options based on their health plans and networks.

Publishing true or average prices helps you avoid the charge master sticker shock. People want to know what their services are actually going to cost them. Some providers are reluctant to publish true pricing. Depending upon your needs, we can either provide the true pricing and true out-of-pocket or we can publish the average contractual price, then if the patient wants to see what the cost will be, we will provide true out-of-pocket. Either way, the consumer always understands the true out-of-pocket. In addition, our solution helps you immediately determine if a patient qualifies for charity.

HealthQRS has the technology platform that allows you to comply with CMS’ final rule, plus give consumers a great shopping experience for your services. Our solution keeps them in-network and provides an easy way for them to set up payment plans right from their smartphones. You are in control of setting your business rules, including discounts and charity. We also support telemedicine, which helps you compete with other providers who do as well.

HealthQRS’ system can support consumer pricing transparency in several different ways:

  1. As part of a HealthQRS system implementation, we provide “ranges of pricing for the most common procedures,” based on payer contracts, that can be posted to your hospital web-site and/or in a secure web portal application.  These prices would not be provider-specific and would not calculate net patient financial responsibility based on current plan balances for the individual consumer.  To address this opportunity, HealthQRS can provide a link to our HealthQRS marketplace application for users who want to get to that level of specificity with their pricing quote.  The link can be made available on the hospital web page or in the hospital’s secure web portal.
  1. HealthQRS can implement a consumer price transparency quoting module that helps hospital personnel leverage a standard price quoting methodology that provides the consumer with a quote based on his/her insurance (and if desired, current plan balances).  Quotes can be printed, emailed or posted to a hospital’s secure web portal in response to their requests.
  1. The HealthQRS Marketplace application can be made available to all consumers. Current patients can be invited via text or email to join the patient engagement and pricing transparency tool.  Alternatively, the tool can be made available for download (or for use, via a secure re-direct or single-sign-on) from within the hospital’s secure web portal.

HealthQRS can make you compliant now and in the future. CMS’ final rule is not the final step that the administration is going to take regarding price transparency. This is the first step of many changes coming your way. Our system helps you today and in the future. We take the worry and hassle out of complying. We also help you turn this regulation into an opportunity to market yourself to consumers. While other providers are posting charge masters and scaring people away, you can provide true pricing and help people pay for their services. You can help them understand their exact costs. People shop with organizations that make it easy to shop with them.

HealthQRS can set you up with a full retail site right now. Our platform is ready. We provide you with the infrastructure to create an online experience for consumers including accurate pricing (not just estimates). We enable telehealth connectivity as well. Our technology enables people to connect to more cost-effective, consumer-oriented healthcare options and we keep them in-network. HealthQRS integrates fully to your EHR and can also enhance your existing portals and other patient engagement solutions and improve your meaningful use numbers and increase meaningful use funds.

We are so much more than a portal. HealthQRS is the perfect vertical application for integrated delivery networks. 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 shop, see actual costs, schedule and pay for services with a few finger taps.

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. Why not contact us right now to schedule a personalized demo?

HealthQRS offers you a chance to beat your competition as you comply with CMS’ final rule. We can help you be ready for January 1 and make the new year your best one yet.

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[1] Kelly Gooch, “92% of healthcare providers concerned about CMS price transparency rule, survey finds,” Becker’s Hospital Review, Nov. 7, 2018, https://www.beckershospitalreview.com/finance/92-of-healthcare-providers-concerned-about-cms-price-transparency-rule-survey-finds.html?origin=rcme&utm_source=rcme

 

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