Proposed price transparency legislation worries providers about disruption. Disruption is already here. But you can embrace it and win
When the U.S. House of Representatives, the Senate and the Trump Administration all agree on something, it means it’s a big deal and is likely going to happen. That’s the current situation with price transparency in healthcare. Both the White House and Congress are pushing for legislation that will help consumers know, upfront, what their out-of-pocket will be, stay safe from being surprised by their bills and from receiving balanced bills.
Articles in The Wall Street Journal, Becker’s Hospital Review and Modern Healthcare shows how Democrats, Republicans and the Trump administration are working together on behalf of American consumers who cannot sustain the pressure of increased and non-transparent healthcare prices, as well as how providers are voicing concerns about the disruption to the healthcare system that this type of legislation could pose.
Susannah Luthi with Modern Healthcare reports:
“Sen. Ron Wyden (D-Ore.) on Wednesday proposed a bill requiring insurers to tell people what they would have to pay out of pocket for any in-network treatment or prescription drug.
The bill is part of the broader push in Congress and from the Trump administration to force healthcare prices out in the open.
The Senate health committee led by Sen. Lamar Alexander (R-Tenn.) is expected to release a packet of bills shortly all aimed at cutting some of the fat out of the healthcare system to save money for patients and the government.”
Kelly Gooch with Becker’s Hospital Review references an article in The Wall Street Journal that discusses the far-reaching plans. Basically, the efforts will touch patients, insurers, hospitals and providers in an effort to provide patients “with their total price of care up front, regardless of whether the healthcare provider is in the patient’s insurance network or not, according to the Journal, which cites people familiar with the discussions.”
Another Becker’s article, “Healthcare reacts to federal push for surprise-billing protections,” cites a number of healthcare associations’ concerns. The American Hospital Association, American College of Emergency Physicians, American Medical Association and Federation of American Hospitals are pushing back with various arguments around bundled pricing having unintended consequences and disrupting the industry.
Really? Disruption? Wake up, folks. What do you think has been happening in the past few years? Your profession IS ALREADY DISRUPTED by consumers who are fed up with not knowing what healthcare is going to cost, and by companies who see the reality, know how to meet consumers’ needs, and are taking those consumers away from you. Companies like Amazon and Walmart who are giving consumers less expensive and more convenient healthcare options than providers are. And consumers are flocking to these alternatives and leaving providers in the dust.
While providers are busy pointing fingers at payers, and payers are busy pointing fingers at providers, smart retailers are not-so-quietly moving in and taking over. And savvy consumers are following the lead.
People vote with their wallets and their feet. When they put off receiving healthcare services because they fear that they can’t pay for it and they don’t know what it’s going to cost them, who do you think is going to win their business? Companies who make it easy for them? Or providers who stick with the status quo, business as usual and simply put chargemasters someplace deep within their websites?
As politicians on both sides come together to write, pass and enact legislation, instead of moaning about disruption, perhaps it’s time to make a move.
You can get ahead of the legislation and be proactive in a world that has already been disrupted. You can offer complete, and we mean complete, price transparency by letting people know exactly what their out-of-pocket costs will be. Not just estimates. Actual out-of-pocket.
You can offer consumers less expensive and more efficient alternatives such as telehealth and give them a way to access this from their phones. You need a platform that will enable you to partner with companies like CVS/Aetna, Walmart and Humana’s Doctor on Demand. A platform that offers a complete e-commerce process for your members/employees/customers that makes it easy to refer procedures Doctor on Demand or CVS doesn’t offer.
One, easy-to-use app allows you to do all of this and more. This app is not expensive and it’s simple to integrate into your existing systems.
The app gives people access to an extremely robust system that works behind the scenes allowing you to do exactly what this new legislation will require you to do. Bundled payments? A snap. Keeping people in network? Absolutely. Giving them a way to shop for your procedures and services? Touch of a button.
People want the Amazon experience. And you can give it to them. But you need the technology infrastructure to provide this. HealthQRS’ platform enables telehealth connectivity and you can take advantage of it immediately to start marketing telehealth visits to your consumers.
With HealthQRS, consumers can schedule a telehealth visit, pay for it, and have the visit right from the app on their smartphone. Talk about convenience. And if they need more than telehealth, we enable that as well. HealthQRS allows patients to see what their actual out-of-pocket expenses will be before they schedule services. Not estimates. Actual prices.
Our technology enables people to connect to more cost-effective, consumer-oriented healthcare options and we keep them in-network. HealthQRS integrates fully to EHRs and can also enhance existing portals and other patient engagement solutions, improve meaningful use numbers and increase meaningful use funds.
HealthQRS allows you to offer an entire online retail experience with one, easy-to-use platform. And we have developed the only complete e-commerce platform for healthcare on the market. HealthQRS is an e-commerce platform that you can brand for your hospital and that will keep consumers in-network. Our ecommerce platform gives people a full, rich retail experience in healthcare. When they login to the app on their smartphones, tablets or PCs, they see your logo and they think you are providing this experience. And you ARE providing the experience … HealthQRS is providing the platform.
How do we do all of this?
Our solution is built with complicated algorithms that use real-time data: the actual payer contracts by provider + insurance verification information + charity + other business rules to provide consumers with a true out-of-pocket per patient per procedure. HealthQRS interfaces with virtually any existing practice management system and electronic medical record. We have over 30 modules that work independently or all together depending upon your needs to provide a holistic, seamless, total experience for the consumer from start to finish. We combine navigation, the capability to make an appointment, referral management (if needed), payment management and so much more than we can list here.
Our solution is simple to use. We invite you to see for yourself with this 2-minute video of the HealthQRS price transparency tool. Click on this link, then you’ll be instructed to download and watch: https://s3.amazonaws.com/hqrs.media/_misc/Screen+Recording+2018-11-29+at+17.30.45.mov
Developing a solution of this magnitude didn’t happen overnight. We started with the consumer experience in mind and spent years drawing on the knowledge of best-of-breed experts to perfect, fine tune and put together this complicated, yet complete solution for medical e-commerce.
In fact, 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 also invite you to watch our user-friendly app video that you can use to win consumers as well as our point-of-service solution video that may interest you. You can also check out our E-Commerce Medical Marketplace Flyer for more information.
 Susannah Luthi, “New Senate bill targets insurers in transparency push,” Modern Healthcare, May 16, 2019, https://www.modernhealthcare.com/government/new-senate-bill-targets-insurers-transparency-push?utm_source=modern-healthcare-daily-dose-thursday&utm_medium=email&utm_campaign=20190516&utm_content=article6-headline
 Kelly Gooch, “Trump administration pushes for healthcare price transparency: 6 things to know,” Becker’s Hospital Review, May 16, 2019, https://www.beckershospitalreview.com/finance/trump-administration-pushes-for-healthcare-price-transparency-6-things-to-know.html?oly_enc_id=2571D2183945E3W
 Kelly Gooch, “Healthcare reacts to federal push for surprise-billing protections,” Becker’s Hospital Review, May 10, 2019, https://www.beckershospitalreview.com/finance/healthcare-reacts-to-federal-push-for-surprise-billing-protections.html?origin=cfoe&utm_source=cfoe