Providing consumers with a retail experience in healthcare can help you comply with CMS’ price transparency rule and leave out the sticker shock of a charge master

by admin 0 Comments

In a few days, you’ll need to be compliant with the Hospital Price Transparency and Disclosure Act of 2018. You can publish a charge master and fulfill your regulatory obligation. But is that the best strategy? Is simply complying going to help increase your volume and your revenues, especially when a charge master will likely result in sticker shock?

Organizations that operate by The Golden Rule usually satisfy customers and keep them coming back. Isn’t that what you really want? Compliance to the letter of the law will get you by, but will it satisfy your patients, people who are really your consumers?

Paul Keckley is a healthcare policy analyst and widely known industry expert. Keckley recently recounted his personal experience with the lack of price transparency and offers high-level insights into what needs to be done for consumers. We recommend reading his article, Hospital Price Transparency: The Long Road Ahead, in its entirety.[1]

We’re going to summarize and share a few highlights about how Keckley’s frustrations and suggestions can help you not only comply with CMS’ new price transparency law, but thrive and outdo your competition if you handle this in a way that will appeal to consumers.

In October, Keckley spent eight hours in the emergency room after collapsing on a golf course due to severe dehydration. He underwent an EKG and MRI to rule out heart and stroke issues. Five weeks after his ordeal, Keckley received his hospital bill for $13,529.05. Over $10K was for the MRI alone.

In an effort to understand the $10,655.85 charge for the MRI, Keckley searched for prices of “MRI neck without contrast” which was the way it was described on his discharge summary. He checked websites for the three local hospitals, which did not list prices, just requests to call a representative. Calls to the representatives resulted in no answers, not even an estimated range. Keckley then searched three price-shopper websites which offered both local and national price ranges, but according to Keckley, “the estimates varied widely and weren’t based specifically on CPT 3100F, the one used by the hospital to receive reimbursement by the insurer.”[2]

Oftentimes price transparency tools are clunky and don’t show true pricing. What is a consumer supposed to do with information that provides price ranges of MRI from $430 – $2409? It’s no wonder most consumers don’t use these tools. It’s important to note the distinction: using pricing tools is different than shopping for prices. People want to know prices. They also want an easy way to find them.

Keckley was frustrated with his experience for a variety of reasons that had to do with billing:

  • Separate bills
  • Meaningless line-item charges on the hospital bill
  • A lengthy, fruitless experience trying to make sense of the charges – including calling three local hospitals who couldn’t give him an answer
  • Feeling left out of the equation since the hospital billed his insurance before he had a chance to review the costs
  • Receiving the hospital statement five weeks after the fact

Obviously, an emergency situation is different than an outpatient event. And Keckley notes that: “Price transparency for a specific test is only relevant if it’s an outpatient non-emergency occasion where I am not directed to use a specific provider by my insurer.”[3]

But the billing processes resulting in Keckley’s dissatisfaction, are the same billing practices used across all of healthcare, including outpatient. Outpatient services are where you need to be competitive because people have a choice. How can you use CMS’ price transparency rule to your advantage? Follow the Golden Rule: think how you want to be treated when it comes to understanding and paying your healthcare bills and create an environment that provide that same treatment to consumers. Basically, give consumers the Amazon experience in healthcare.

What do consumers want?

  1. To know the actual price before the fact
  2. To know what type of discounts you offer
  3. To understand how they are going to pay and if you offer them terms or some type of line of credit
  4. Convenience such as access to telemedicine
  5. A retail experience like they are used to with everything else they buy

What consumers DON’T want:

  1. Not knowing what the cost will be before the fact
  2. Confusing bills
  3. More bills than they thought they would get
  4. Not being able to pay their bills

HealthQRS’ solution allows you to provide consumers with what they want: A true retail experience in healthcare. HealthQRS has developed the only complete e-commerce platform for healthcare on the market. We give consumers a site that allows them to use their smartphone, tablets or computers to shop, schedule and pay for services and medications and see actual pricing and options based on their health plans and networks. 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

Our solution will help you comply with CMS’ Jan. 1 price transparency rule, but we are much more than a price transparency tool. Our platform has 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.

HealthQRS’ price transparency tool allows you to publish price as well a downloadable readable file that shows realistic pricing, not the charge master.  In addition, we can provide out-of-pocket pricing. Our solution can also capture the user’s information, such as name, email address and phone number.

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. Consumers can access your retail site and shop, schedule and pay for your services via an easy-to-use app on their smartphones or tablets.

We are a software-as-a-service (SaaS), so you have no capital investment, just a low monthly fee. HealthQRS can provide this to you for as low as $500 per month and we can have you compliant by January 1, and not only that, your facilities will be much more attractive to consumers than your competition who is publishing charge master prices.

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.

Contact us right now to schedule a personalized demo. We can help you be compliant by January 1. Even more, we can help you give consumers what they want. And that will keep them coming back to you.

###

[1] Paul Keckley, “Hospital Price Transparency: The Long Road Ahead,” The Keckley Report, Nov. 26, 2018, https://www.paulkeckley.com/the-keckley-report/?category=keckley+report

[2] Keckley, “Hospital Price Transparency,” https://www.paulkeckley.com/the-keckley-report/?category=keckley+report

[3] Keckley, “Hospital Price Transparency,” https://www.paulkeckley.com/the-keckley-report/?category=keckley+report

 

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>