Becker’s lists major obstacles providers must overcome in 2019 and meeting CMS’ minimum requirements for price transparency won’t help

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Hospital compliance with CMS’ price transparency rule has been a mixed bag since January 1. Some have published chargemasters on their home pages while others have buried the lists deeper within the sites requiring users to hunt. And others? Well, according to an article in Modern Healthcare, “In the case of Sutter Health, the information appeared on the system’s website as a blob of incomprehensible script. A Sutter spokeswoman said the data was published in the .JSON format, which she called “a machine-readable format that complies with the rule.”[1]

Regardless of the way the chargemaster is published, even when they find the list, consumers aren’t getting the help that CMS envisioned. Publishing prices according to the letter of the law will make a hospital compliant. But will it attract new business? Or will incomprehensible scripts chase people away to another hospital who is publishing meaningful prices that make sense and actually help consumers understand what their costs will be?

Publishing chargemaster prices, even if it’s on your website’s homepage, isn’t going to pull people toward you.

There is a better way and it’s an easy, quick one to implement. HealthQRS offers a solution where hospitals publish actual pricing that people can access from an app on their phones. This app can serve as a marketing tool for your hospital and help you beat out your competition. You’ll be compliant, you’ll win the game and, in the process, collect your money upfront.

In addition to consumer backlash from chargemaster lists, hospitals face major obstacles in 2019 as outlined in a recent article in Becker’s Hospital Review by Scott Becker and Molly Gamble:

“Hospitals face many different headwinds. This goes into the concept of healthcare as a zero-sum game. There is only so much pie to be shared, and the hospital slice of pie is being attacked or threatened in various areas.”[2] Becker and Gamble list nine headwinds facing hospitals, and we recommend reading the article in its entirety. HealthQRS can help you with at least these four headwinds mentioned in the article:

Bricks and Mortar

HealthQRS can help you cut costs on bricks and mortar by expanding your services to include telemedicine and make it easily accessible from an app.

Slowing Rises in Reimbursement– Federal and Commercial

HealthQRS can help you focus on getting paid for the services you are rendering to patients with high deductibles by implementing a system that allows you, at the time of scheduling, to collect full payment, or at the very least, set up payment plans with consumers.

Lower Commercial Mix

HealthQRS can help you grow your commercial mix by attracting employers. If you help employers lower their healthcare costs, you’ll gain market share. You can do this by offering employers an e-commerce site for their employees that allows them to shop, schedule and pay for services from an easy-to-use app. HealthQRS offers this service, and our solution helps keep employees in network.

The Loss of Ancillary Income

HealthQRS can help you build and market your own, local, centers-of-excellence by contracting with employers to gain the business of their employees.

 Consumerism is here. Use it to stay in the game. Use it to market yourself to patients, to employers/employees, and promote your higher profit margin procedures to improve revenues and operating margins.

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’ 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 or incomprehensible scripts.  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 publish compliant pricing. We can help you face the headwinds. Even more, we can help you give consumers what they want. And that will keep them coming back to you.

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[1] Harris Meyer, “Hospitals vary in publishing CMS chargemaster prices,” Modern Healthcare, Jan. 7, 2019, https://www.modernhealthcare.com/article/20190107/TRANSFORMATION04/190109931?utm_source=modernhealthcare&utm_medium=email&utm_content=20190107-TRANSFORMATION04-190109931&utm_campaign=am

[2] Scott Becker and Molly Gamble, “Healthcare as a zero-sum game: 7 key points,” Becker’s Hospital Review, Dec. 19, 2018, https://www.beckershospitalreview.com/hospital-management-administration/healthcare-as-a-zero-sum-game-7-key-points.html

 

Consumers not buying hospital listed prices

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CMS’ rule on price transparency took effect January 1, but so far, patients aren’t seeing positives from prices published by hospitals. News outlets around the country are reporting negative patient experiences from confusing price lists. It seems that regardless of where you live, figuring out how much your healthcare is actually going to cost hasn’t gotten any easier.

Savannah, GA:

“The prices on Memorial’s website will be the same price you see on St. Josephs Candler’s website but, that’s not the price you’ll pay.

If you have insurance you will most likely pay a lower price negotiated by your employer. That price depends on things like the procedure and specialty.

‘We need an understanding you know it’s vital to our health care services,’ said Gwendolyn Green, a registered nurse.

Green said even as a nurse healthcare pricing is confusing. ‘I mean we should not be left in the dark trying to figure out what’s what and going to Google and trying to Google and find out and you know what it is and what I should and shouldn’t do that’s not essential to our overall healthcare and I mean besides that adds more stress to whatever it is that we are already going through,’ said Green.”[1]

Louisville, KY:

“A federal mandate requiring hospitals in Kentucky and throughout the United States to reveal their once-secret master price lists still leaves patients in the dark.

The government required hospitals to make these lists available to the public with the Affordable Care Act in 2010, but until this week, hospitals were not required to publish them. The prices are now online, but figuring out how much that bag of saline or a medical sensor actually costs is a much different story. It’s buried in pages upon pages of prices, listed with names most don’t know and won’t understand.

‘We have our doubts as to what value it will actually bring to the consumer,’ said Carl Herde, vice president of finance for the Kentucky Hospital Association and the former CFO of Baptist Health. “We think there are better ways to help inform the consumer.’”[2]

Chicago, IL:

“As of Jan. 1, people can find a comprehensive list of medical procedures on all hospital websites, including DMH, HSHS St. Mary’s and Memorial Medical Center.

Area hospitals have almost 2,000 procedures listed on them, but they aren’t in any particular order. They aren’t alphabetized or put into a certain category – rather, they are organized by CPT codes.

‘The problem is, it’s hard to understand the different charges and procedures and how does that interplays with insurance,’ Roszehart said.

According to Roszehart, CPT codes are codes put out by the American Medical Association.

Even though the lists are aimed at being beneficial to patients, when insurance and other factors are accounted for, prices can change or even increase.

‘This was a good first step, but it’s only a first step and it’s not a particularly useful first step,’ Roszehart said. ‘The charges are exactly what an individual will see.’”[3]

Nashville, TN:

“The costs on Vanderbilt University Medical Center’s website is tricky to find.

First, on the main page, you go to patient and visitor info. Click on financial assistance. Then, you’ll see a tab on the left side of the screen that says “our charges.”  Click on another link that says “view list of charges.”  Then agree to terms and conditions, enter in a valid email address.

Once you’ve done all that, you’ll find a complete list of charges for drugs, supplies, and other standard charges for hospital procedures.”[4]

There’s a better way

There is a way to comply with the price transparency rule AND satisfy patients’ need to know their costs. Why not put a price list together that helps, rather than hurts you? Something the consumer can actually use, that won’t put them off, but will attract them to you.

People want to know what their costs are actually going to be. They want to know if there are discounts for pre-payment. Are there terms? Do they qualify for charity?

HealthQRS can help you provide actual pricing and all of the bells and whistles that consumers expect from any shopping experience.

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 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 price-transparency compliant, and not only that, your facilities will be much more attractive to consumers than your competition who is publishing charge master prices.

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. 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

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 and be compliant by January 1.

###

[1] Alex Bozarjian, “Hospitals must post prices online starting Jan. 1,” WSAV, Jan 2, 2019, https://www.wsav.com/news/local-news/hospitals-must-post-prices-online-starting-jan-1/1684066834

[2] Gilbert Corsey, “Patients confused as Louisville-area hospitals post inflated prices online,” WDRB, Jan 4, 2019, https://www.wdrb.com/news/patients-confused-as-louisville-area-hospitals-post-inflated-prices-online/article_6097985a-0f98-11e9-b586-8bc972461ab8.html

[3] Madison O’Brien, “New price transparency in hospitals seems not so transparent with patients,” WANDTV, Jan. 2, 2019, https://www.wandtv.com/news/new-price-transparency-in-hospitals-seems-not-so-transparent-with/article_5dd6203a-0ee1-11e9-8e61-ef13930779f1.html

[4] Edward Burch, “New law requires hospitals to show procedure prices online” WSMV, Jan 2, 2019, https://www.wsmv.com/news/new-law-requires-hospitals-to-show-procedure-prices-online/article_2d8115c0-0ec8-11e9-9692-ebb468023b4a.html

Moody’s and Fitch see pressure and unstable profits for hospitals in 2019

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When it comes to net revenue, life is hard for most hospital CFOs. And 2019 doesn’t look to be much easier. While in some cases revenues may have gone up, the revenue mix is causing havoc. What used to be Medicare, Medicaid and commercial insurance paying the bills has moved to higher patient self-pay in the mix, resulting in more bad debt.

Moody’s and Fitch both predict dour outlooks for hospitals in the coming year:

Moody’s:

Moody’s Investors Service has “issued a negative outlook on the nonprofit healthcare and hospital sector for 2019,” according to an article in Becker’s Hospital Review.[1] Citing things like flat or declining cash flow and expenses outplacing revenues, Moody’s also sees “Hospital bad debt growing to 8 to 9 percent next year as health plans place greater financial burden on patients. An aging population will increase hospital reliance on Medicare, which will also constrain revenue growth.”[2]

Fitch:

“Fitch Ratings expects healthcare pricing and profit margins to be under pressure next year, according to the rating agency’s 2019 Outlook Report.[3]

“’Most disruptive threats to healthcare business models boil down to an attack on pricing power, including outside industry competitive upstarts, government price setting and consumer and employer efforts to force lower pricing,’ said Megan Neuburger, managing director at Fitch.”[4]

When volumes are going up, but profitable business is going down, and you’re not collecting from the consumer, and Moody’s and Fitch predict further instability in 2019, it’s time to take action for your own hospital and change your own fortunes.

It’s time to embrace consumerism because it’s truly here and only going to grow in healthcare. And maybe it’s time to enhance your efforts with a solution that you can implement today, that will fully integrate with your revenue cycle management software and your EHR. It’s called HealthQRS.

HealthQRS’ solution allows you to provide consumers with what they want: An Amazon-like 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.

As a first step in moving toward consumerism, you can offer your consumer/patients more of a retail experience in price transparency with our extremely economical price transparency tool. We invite you to watch a 2-minute video of the HealthQRS price transparency tool to see how simple this is to implement. 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, yet 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] Ayla Ellison, “Outlook is negative for nonprofit hospital sector, Moody’s says,” Becker’s Hospital Review, Dec. 5, 2018, https://www.beckershospitalreview.com/finance/outlook-is-negative-for-nonprofit-hospital-sector-moody-s-says.html

[2] Ellison, “Outlook is negative,” Becker’s Hospital Review, Dec. 5, 2018, https://www.beckershospitalreview.com/finance/outlook-is-negative-for-nonprofit-hospital-sector-moody-s-says.html

[3] Ayla Ellison, “Fitch: Healthcare profit margins will face pressure in 2019,” Becker’s Hospital Review, Dec. 3, 2018, https://www.beckershospitalreview.com/finance/fitch-healthcare-profit-margins-will-face-pressure-in-2019.html

 

[4] Ellison, “Fitch,” Becker’s Hospital Review, Dec. 3, 2018, https://www.beckershospitalreview.com/finance/fitch-healthcare-profit-margins-will-face-pressure-in-2019.html

CMS’ new price transparency tool is a good start. HealthQRS can help you provide more and avoid sticker shock

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CMS has released a price tool for Medicare patients to look up costs for hospital outpatient surgeries. The tool allows patients to type in a procedure and then see a list of procedures based by code. Once the user selects a specific procedure from that list, another list is shown with averages comparing patient out-of-pocket at ambulatory surgical centers vs. hospital outpatient.

You are just days away from needing to publish a price list. We’ve talked with hospital executives who are concerned that publishing the rack rate will scare patients away. And it’s likely to. Why not put a proper price list together that helps, rather than hurts you? Something the consumer can actually use, that won’t put them off, but will attract them to you.

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 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.

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. 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

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 and be compliant by January 1.

 

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

 

Ignoring consumerism leads to lower volume. AHA and HFMA offer a few tips on how to share prices with consumers

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Revenue loss after revenue loss. Losses getting bigger each year. Financial woes for hospitals in the U.S. are nothing new. But things are getting worse and showing no signs of improving. Take LifePoint Health and Community Health Systems. Two huge hospital systems whose revenues have dropped and losses have grown and each year reveals a bleaker picture.

According to an article in Becker’s Hospital Review, “LifePoint’s financials were affected by lower patient volume. The company said admissions, inpatient surgeries, outpatient surgeries and emergency room visits all declined year over year in the first quarter of 2018. After factoring in operating expenses and one-time charges, LifePoint ended the first quarter of this year with a net loss attributable to the company of $8.8 million. That’s compared to the first quarter of 2017, when the company posted net income of $59.9 million.”[1]

HealthCareDive reported that Community Health Systems third quarter net operating revenues had a decrease of 5.9% from the year before, a massive shareholder loss of $325 million, (a $215 million greater loss than the year before). “Lower volume was partially to blame, as the quarter saw a 12.4% decrease in total admissions and a 12.2% decrease in total adjusted admissions compared with the same period in 2017.”[2]

Then there are the community hospitals. Almost every week we see reports of bankruptcies and closures. Community hospitals make up 85% of all hospitals in the country.[3] What is happening to our healthcare systems? Why is the situation so dire?

U.S. hospital systems continue to ignore the reality of consumerism in healthcare. And yet, consumerism IS a major part of healthcare and it’s here to stay. People vote with their feet, with convenience and price dominating their choices. Portals and websites are not effective and do not provide a retail experience. For outpatient services, the choices are growing, hitting hospitals with more and more competition.

Walmart, already a player in healthcare, has just announced plans to build clinics in their parking lots, yet one more nail in healthcare systems’ coffins. A Walmart spokesperson told Business Insider, “We envision a more robust and dynamic shopping experience that combines entertainment venues, curated local food vendors, health and fitness services as well as recreational opportunities in a way that connects and engages with the community.”[4]

Convenience and price. Two of the main factors that draw consumers. Walmart and Amazon have perfected these drawing cards. Providing consumers with the Amazon retail experience in healthcare is a way to combat the myriad of disrupters and competition facing traditional hospital systems.

Consumers are the new payers in healthcare and they are worried about the high costs of healthcare and tired of not being able to get a straight answer about the cost before services are rendered. Many are either putting off healthcare services or not able to pay once they receive them. According to a survey referenced in Becker’s Hospital Review, “twenty-seven percent of respondents with children said they delayed care in the last two years because they couldn’t afford it.” [5]  And 46% of people “said they would be concerned about their ability to cover an unexpected medical expense of $1,000 or more.”[6] That’s up from 39% just last year.

The upcoming price transparency rules by CMS are just the beginning of regulations within healthcare that the administration is putting into place to help consumers. Are you going to take the path of least resistance and publish a charge master? That might satisfy the government, but it will scare off the consumer who has more options than ever before.

To help hospitals prepare for price transparency, The American Hospital Association published a price toolkit, and part of it contains suggestions from the Healthcare Financial Management Association (HFMA) to prepare for price transparency. One tip stood out to us because it helps people easily find the prices:

Consider how care purchasers will access the information you provide. Price information might be publicly posted on a website, made available on a password-protected website (e.g., for health plan members), or made available in response to an inquiry submitted via website or made by phone. However you plan to provide access to price information, make sure that patients can easily find out how to get it.”[7]

HealthQRS provides the way to publish prices on a website that can be easily accessed by people. We have the platform to help you with this and we can have you ready to go in a matter of weeks.

RevCycleIntelligence also published tips for providers to improve their price transparency.[8] We can help with each one:

  1. Prepare for Hospital Price Transparency

HealthQRS allows you to provide actual prices, not just estimates, in an easy-to-use smartphone app where people can stay in network, shop for services, schedule with you, and pay for those services right from the app. You can set business rules to allow for discounts based on early payments, charity, and whatever else you wish to structure.

  1. Consider a Bundled Pricing Strategy

Our solution allows you to bundle pricing. This helps avoid surprise billing, which, in turn, allows for more satisfied patients. It also ensures that more providers actually receive their money.

  1. Educate Staff on How to Discuss Prices and Patient Financial Responsibility

Our point-of-service solution has interactive, intuitive scripts that your scheduling department, registrars and front-office staff can use to discuss prices and patient responsibility. Discounts can be offered at scheduling and check-in, and staff members can instantly see actual patient responsibility, not just estimates.

  1. Implement Price Transparency Tools

Within a few weeks, we can have your entire system up and running with fully-implemented price transparency tools. We go beyond just providing a transparency tool to meet CMS requirements. We allow you to meet the requirements, and we provide an easy-to-use retail platform that gives consumers the Amazon retail experience. Our solution integrates fully with your EHR and allows you to provide meaningful use numbers as well.

As you face mounting competition, your hospital system does not have to succumb like the others. You can offer people a better experience. You can give them the Amazon retail experience in healthcare and HealthQRS can help you do it right now.

HealthQRS can set you up with a full retail site right now. Our platform is ready and we can help you proactively publish prices and beat the competition who is digging in their heels waiting for the forced mandates. Walmart could even use our platform for their employees and their customers.

HealthQRS provides 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.

HealthQRS is the perfect vertical application for integrated delivery networks. We provide regulation compliance and serve as a marketing tool for your facilities. In addition, HealthQRS allows you to be compliant with the new CMS transparency rules beginning Jan. 1, 2019.

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?

Walmart is ready to snap up consumers looking for alternatives because they are giving them an easy healthcare shopping experience. You need to be giving your consumers that same level of customer service if you want to compete.

###

[1] Ayla Ellison, “LifePoint slips to $8.8M net loss as admissions decline,” Becker’s Hospital Review, May 4, 2018, https://www.beckershospitalreview.com/finance/lifepoint-slips-to-8-8m-net-loss-as-admissions-decline.html

[2] Rebecca Pifer, “CHS sees massive Q3 net loss amid weak volume, aftershocks of HMA settlement,” HealthCareDive, Oct. 30, 2018, https://www.healthcaredive.com/news/chs-sees-massive-q3-net-loss-amid-weak-volume-aftershocks-of-hma-settlemen/540868/

[3] Brooke Murphy, “50 things to know about the hospital industry | 2017,” Becker’s Hospital Review, Jan. 25, 2017, https://www.beckershospitalreview.com/hospital-management-administration/50-things-to-know-about-the-hospital-industry-2017.html

[4] Áine Cain, “Walmart is building ‘town centers’ in its parking lots – and it could redefine the one-stop shop,” Business Insider, Oct. 26, 2018, https://www.businessinsider.com/walmart-town-centers-parking-lots-2018-10

[5] Kelly Gooch, “27% of families are putting off medical care because of costs, survey finds,” Becker’s Hospital Review, Oct. 30, 2018, https://www.beckershospitalreview.com/finance/27-of-families-are-putting-off-medical-care-because-of-costs-survey-finds.html

[6] Gooch, “27% of families,” Becker’s Hospital Review, Oct. 30, 2018, https://www.beckershospitalreview.com/finance/27-of-families-are-putting-off-medical-care-because-of-costs-survey-finds.html

[7] American Hospital Association, “Achieving Price Transparency for Consumers: A Toolkit for Hospitals,”: “Preparing for Price Transparency: A Five-Point Checklist,” Healthcare Financial Management Association, http://www.ahacommunityconnections.org/content/14transparency-5ptchecklist.pdf

[8] Jacqueline LaPointe, “4 Strategies for Providers to Improve Hospital Price Transparency,” RevCycleIntelligence, June 4, 2018, https://revcycleintelligence.com/news/4-strategies-for-providers-to-improve-hospital-price-transparency

 

What do Azar and Walmart have in common? Helping healthcare consumers. What are you doing?

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Remember playing hide-and-seek, when the person who was “it” would count to 10 and then yell: “Ready or not, here I come!” as everyone else scrambled to hide? Well, in the game of prices and healthcare, ready or not, price transparency is here. With the administration’s concerted effort to ensure that consumers understand what their healthcare costs will be, Azar’s latest proposed rule around pharmaceutical drugs should come as no surprise. The rule will require pharmaceutical companies to disclose list prices in TV ads, allowing consumers to “learn the cost wholesalers pay for most drugs covered by Medicare and Medicaid.”[1] Yet, the announcement immediately put pharma into a tailspin with policy experts bashing the idea because consumers might become confused.

Confused? Really? Give us a little credit. When we walk into a hospital we don’t stop being savvy consumers. We are experts at shopping and paying for products in stores and on our smartphones and we don’t get confused when we see a list of prices and options. We also know how to ask registrars and schedulers how much our healthcare services are going to cost. So, we aren’t confused. And we aren’t stupid. What we are is dissatisfied because we aren’t getting solid answers about how much our services and procedures are going to cost before treatment.

And guess what? Dissatisfied patients are less likely to willingly pay for their healthcare services, according to a recent survey of 500 random consumers who had an experience with a hospital business office. To put it another way, “patients are more likely to pay their bills in full if they are satisfied with their business office experience.”[2]

Is it consumer confusion that concerns healthcare providers and pharma or is it worry that people will realize what they are being charged is way too much when they see true pricing?

Aurora Aguilar, in an editorial for Modern Healthcare, writes: “Why would an industry that so often references value need a shove? Because hospitals and drugmakers still shy away from revealing what patients will pay for their services and products despite the near-deafening chorus from consumers begging for financial relief.”[3]

While providers and pharma waste time figuring out ways to sort of publish prices for consumers, Walmart is actually doing something about the skyrocketing cost of healthcare. Retailers, especially Walmart, are experts when it comes to understanding what consumers want. And they listen to consumers because their bottom line depends on it. Walmart has seen that customers are spending less on their retail products because they are forced to spend their money on healthcare and medicine. Walmart has proactively entered the game in several ways such as partnering with health plans to encourage customers to buy healthier foods such as fruits and vegetables at its stores, operating health clinics across the country, and entering into contracts with major providers to offer centers of excellence for large ticket procedures such as knee replacements. And now Walmart is into telemedicine. Recently, in partnership with RB, a global health and hygiene company, Walmart has “launched a telehealth initiative with Doctor On Demand.”[4]

Retailers could teach providers and pharma a thing or two, beginning with the fact that consumers aren’t stupid. They are tired of being forced to deal with antiquated back office methods in healthcare. It’s time to get with the times and treat patients like the consumers they really are. Price transparency is a good start. And by price transparency we don’t mean publishing a charge master or forcing people to click on links that then give them estimates on what their drug costs will be.

We are talking about providing people with a true retail experience in healthcare. Giving them a site that  allows them to shop for services and medications and see actual pricing and options based on their health plans and networks.

HealthQRS can set you up with a full retail site right now. Our platform is ready and we can help you proactively publish prices and beat the competition who is digging in their heels waiting for the forced mandates. Walmart could even use our platform for their employees and their customers.

HealthQRS provides 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.

HealthQRS is the perfect vertical application for integrated delivery networks. We provide regulation compliance and serve as a marketing tool for your facilities. In addition, HealthQRS allows you to be compliant with the new CMS transparency rules beginning Jan. 1, 2019.

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?

Be assured, Walmart is going to give their consumers an easy shopping experience and help them with their healthcare needs along the way. You need to be giving your consumers that same level of customer service.

###

[1] Aurora Aguilar, “Editorial: Price transparency’s day of reckoning,” Modern Healthcare, Oct. 18, 2018 http://www.modernhealthcare.com/article/20181018/NEWS/181019883

[2] Angie Stewart, “Patient experience is tied to payment collections – 5 survey findings,” Becker’s ASC Review, Oct. 15, 2018, https://www.beckersasc.com/asc-coding-billing-and-collections/patient-experience-is-tied-to-payment-collections-5-survey-findings.html

[3] Aguilar, “Editorial: Price transparency’s day,” Modern Healthcare, Oct. 18, 2018 http://www.modernhealthcare.com/article/20181018/NEWS/181019883

[4] Ayla Ellison, “Walmart launches telehealth initiative with Doctor On Demand,” Becker’s Hospital Review, Oct. 23, 2018, https://www.beckershospitalreview.com/telehealth/walmart-launches-telehealth-initiative-with-doctor-on-demand.html?origin=cioe&utm_source=cioe

 

Patient portals aren’t saving the healthcare industry. The Amazon experience could.

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All over the country, hospitals are succumbing to unsustainable business models. Since Jan. 1, 22 hospitals have either closed or filed for bankruptcy. Larger providers like Ascension and Cleveland Clinic are also suffering from poor financial results. Blame is placed on many factors. But we suggest there is a common thread running through the financial devastation in healthcare: the failure to embrace consumerism and give people the Amazon experience in healthcare.

Many hospital leaders will say they are, in fact, doing everything they can to enhance patient satisfaction. They will show you their patient portals and the patient engagement efforts they have put in place. But notice the language: they are still calling their customers “patients.” And their answer to “patient engagement” is to give people portals.

People want to be treated like consumers, and money spent on portals simply isn’t paying off. Even though by 2015 nearly 90 percent of eligible providers and hospitals offered patients access to portals, by 2017, according to the Government Accountability Office (GAO), only “15 percent of eligible providers and 30 percent of hospitals saw any patients view, download, or transmit their patient portal data.”[1]

Portals are not a match for – or replacement of – an ecommerce platform that gives patients an Amazon experience in healthcare. They are not e-commerce platforms. People want to more than access their records. They want the ability to shop for services, see actual prices, schedule the services and pay (or at least make a down payment) from their smartphones. If they can also access their records from the same app, and communicate with their providers, and even see a teledoc, so much the better.

The HealthQRS app does all that. The HealthQRS ecommerce platform fully integrates with existing EHRs, allows patients to access their records, allows them to shop for healthcare services, and provides them the Amazon experience in healthcare.

A feature article about portals in Patient Engagement HIT says that “organizations are exploring how to leverage additional patient engagement technologies and feature to supplement the capabilities of patient portals and create seamless, holistic experiences for users.”[2] Really? With portals?

If providers are truly looking to create great experiences for users, then start treating those users like consumers and give them a retail experience in healthcare.

HealthQRS is not a replacement for EHRs. We are a complement that adds incredible value to the EHR.

We can partner and integrate with any EHR system to make it be everything you need it to be. We provide the front-end, retail shop at the point-of-service while your EHR continues to provide the necessary clinical and behind-the-scenes back office tools. We can be the value-added solution that provides a seamless experience, from start-to-finish, for your consumers and your employees. And, with HealthQRS there is no duplication of entry. Your staff doesn’t have to enter the same information into different legacy systems. We merge everything together behind-the-scenes and provide an easy-to-use retail experience for consumers and an easy point-of-service experience for your staff.

For example, many provider employees have to re-key everything they do because they don’t have one solution that automatically converges different systems. HealthQRS automatically posts payments to EHR systems. We automatically verify insurance, medical necessity, charity, our system can send all of that to your EHR.

HealthQRS gives you what you need to compete on many levels. Our solution provides people a full retail experience in healthcare just like they are used to receiving from Amazon for retail goods. From their smartphones, consumers can search for services and procedures in their network, see true prices – not just estimates – schedule the service, search for discounts, pay for the service or set up payment plans, find transportation, receive appointment alerts, wellness alerts, and even see a doctor via telemedicine. You name it. We offer it.

HealthQRS provides 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.

HealthQRS is the perfect vertical application for integrated delivery networks. We provide regulation compliance and serve as a marketing tool for your facilities. In addition, HealthQRS allows you to be compliant with the new CMS transparency rules beginning Jan. 1, 2019.

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? Move beyond portals and give people what they really want. Treat them like consumers.

###

[1] Sara Heath, “Moving Beyond the Portal with Patient Engagement Technologies,” Patient Engagement HIT, https://patientengagementhit.com/features/moving-beyond-the-portal-with-patient-engagement-technologies?eid=CXTEL000000260100&elqCampaignId=7078&elqTrackId=9b618c67503a467cb8ba9e2e737d0d83&elq=2c277b53f5b444fc855b17bb07adc73c&elqaid=7497&elqat=1&elqCampaignId=7078

[2] Heath, “Moving Beyond the Portal,” https://patientengagementhit.com/features/moving-beyond-the-portal-with-patient-engagement-technologies?eid=CXTEL000000260100&elqCampaignId=7078&elqTrackId=9b618c67503a467cb8ba9e2e737d0d83&elq=2c277b53f5b444fc855b17bb07adc73c&elqaid=7497&elqat=1&elqCampaignId=7078

State employees of Montana are forcing consumerism in healthcare

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Embracing consumerism. Employers are doing it. So are states. It’s time for providers to take heed and treat patients like the consumers they truly are. Giving them the Amazon experience in healthcare by providing price transparency is a big start. When people shop on the Amazon app, they don’t get only estimates or a sign saying, “buy now and get a surprise bill later.”

Consumers of Amazon goods know exactly what their costs will be. And so it should be with healthcare. It shouldn’t be that hard to do. After all, the platform exists right now that would allow providers to do just that: HealthQRS. But we’ll get to that in a moment. First, let’s discuss how one woman helped an entire state to embrace price transparency and consumerism in healthcare.

The following account of Marilyn Bartlett is taken from an article GPB News published Oct. 2, 2018, entitled “A Tough Negotiator Proves Employers Can Bargain Down Health Care Prices.”[1]

Marilyn Bartlett was a 64-year-old grandmother who, almost single-handedly pulled Montana from the brink with a radical strategy to bail out the state’s floundering benefit plan for its 30,000 employees and their families. Bartlett knew her way around a health plan with 13 years of experience as controller for a Blue Cross Blue Shield plan and also as a CFO for a benefits administration company. She pitched a two-fold strategy to the state’s Department of Administration (that the department liked and hired her to manage) to:

  1. Tell the state’s hospitals what the plan would pay. Take it or leave it.
  2. Demand a full accounting from the company managing drug costs. If the company wouldn’t reveal any side deals it had with drugmakers, replace the company.

More than half of American workers are covered by self-funded plans and Montana’s state employees are no different. When Bartlett asked to see detailed information about how much the plan paid its payer for pricing terms, she was refused. The payer said that contracts with hospitals were secret.

Yet she was expected to pay anyway? Apparently so. After quite a bit of back and forth and not being able to gain access to true contract pricing, Bartlett decided to go rogue and set her own prices for the hospitals. As she delved deeper, Bartlett found that prices for the same procedure differed dramatically. For example, one hospital gave a 7% discount for a knee replacement on a charge of $25,000 that reduced the amount to $23,250. Another hospital, for the same procedure, gave a better discount at 10%, but its beginning price was $115,000 with the discount bringing the bill to $103,500. So, simply looking at the discount percentage didn’t reveal actual costs.

With so much price variation, Bartlett decided to use prices set by Medicare as the reference point, because its prices are public as well as adjusted due to location and other factors. Montana’s plan would pay hospitals a set percentage above the Medicare amount, a method knows as ‘reference-based pricing,’ making it impossible for the hospitals to arbitrarily raise their prices.

Literally forcing providers and drug companies to reveal pricing led this woman to turn Montana’s situation around. Mission accomplished, Bartlett left her position as administrator of the state employee health plan and now works for the office of the Montana insurance commissioner to take on pharmacy benefit managers.

Takeaways?

Price transparency is possible. And, as employers, including states, make a stand, it will become harder for providers and payers to keep prices secret. Providers may not want to play ball at this point, but the time is quickly coming when they will have to. In less than three months, January 1, 2019, CMS will force providers to show, at the very least, their chargemaster prices. CMS’ 2019 inpatient and long-term care hospital prospective payment system (IPPS/LTCH PPS) rule is requiring from providers:

  • Greater price transparency
  • Interoperability
  • Significant burden reduction
  • Publication via the Internet

Simply posting a PDF is not good enough. Providers will need to have information that can be accessed easily by consumers through an app. HealthQRS offers a solution that allows you to comply with each requirement of the CMS rule. We offer a platform where you can negotiate directly with employers and states, like the state of Montana, to ensure that you gain their business. Not only that, we make it easy on all counts.

In June 2018, RevCycleIntelligence published tips for providers to improve their price transparency.[2] We can help with each one:

  1. Prepare for Hospital Price Transparency

HealthQRS allows you to provide actual prices, not just estimates, in an easy-to-use smartphone app where people can stay in network, shop for services, schedule with you, and pay for those services right from the app. You can set business rules to allow for discounts based on early payments, charity, and whatever else you wish to structure.

  1. Consider a Bundled Pricing Strategy

Our solution allows you to bundle pricing. This helps avoid surprise billing, which, in turn, allows for more satisfied patients. It also ensures that more providers actually receive their money.

  1. Educate Staff on How to Discuss Prices and Patient Financial Responsibility

Our point-of-service solution has interactive, intuitive scripts that your scheduling department, registrars and front-office staff can use to discuss prices and patient responsibility. Discounts can be offered at scheduling and check-in, and staff members can instantly see actual patient responsibility, not just estimates.

  1. Implement Price Transparency Tools

Within a few weeks, we can have your entire system up and running with fully-implemented price transparency tools. Our solution integrates fully with your EHR and allows you to provide meaningful use numbers as well.

HealthQRS allows you to be compliant with the new CMS transparency rules beginning Jan. 1, 2019. Our platform is the perfect vertical application for integrated delivery networks and offers you the infrastructure to give your patients more than just price transparency. You can treat them like consumers and offer them a complete retail experience just like Amazon which will serve as a powerful marketing tool for your facilities. And we can fit easily within your budget, because we are a software-as-a-service (SaaS), so you have no capital investment, just a low monthly fee.

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? Embrace consumerism today and get a head start on January 1.

###

[1] Editor, “A Tough Negotiator Proves Employers Can Bargain Down Health Care Prices,” GPB News, Oct. 2, 2018, http://www.gpbnews.org/post/tough-negotiator-proves-employers-can-bargain-down-health-care-prices

[2] Jacqueline LaPointe, “4 Strategies for Providers to Improve Hospital Price Transparency,” RevCycleIntelligence, June 4, 2018, https://revcycleintelligence.com/news/4-strategies-for-providers-to-improve-hospital-price-transparency

 

The main reason Apple and Amazon are opening clinics? Healthcare providers aren’t responding to consumerism

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When healthcare providers can’t – and won’t – keep up with every other industry in embracing consumerism, companies are forced to take drastic measures. The old adage, stick to what you do well, is being challenged by Amazon and Apple. To control healthcare costs, the giant corporations are taking matters into their own hands as they establish and operate their own medical clinics for their employees. Companies that have on-premise medical clinics for employees is nothing new or unique. But Apple and Amazon, are actually hiring their own staff to run these clinics.

According to an article in Becker’s Hospital Review, “Amazon will launch a primary care clinic in the coming months for a small number of employees at its headquarters in Seattle. After considering outsourcing clinic operations and hearing proposals from vendors, Amazon decided to develop the clinics internally and began hiring staff in July.”[1] Not only Amazon, but Apple is creating AC Wellness, “a group of primary health clinics for its employees and their families. In August, Apple had hired more than 40 people to staff the clinics.”[2]

We recently attended Becker’s healthcare conference in Chicago. In a three-day conference, there was only one session that had “consumerism” as part of its title. We attended that session, but not much was discussed about consumerism. And yet consumerism is the single largest thing impacting healthcare right now.

KaufmanHall recently published the results of its Healthcare Consumerism Index.[3] MediRevv, a revenue cycle company, recaps the study’s key findings in an article, Healthcare Consumerism: The Disconnect Between Knowing What Needs to Change and Putting a Strategy in Place to Get There:[4]

Pricing 

According to the survey results pricing pain points are a huge mitigating factor in consumerism. In addition to better financial transparency of how much medical services cost, the bigger question for debate is how much medical services should cost. The survey shows there is a long way to go to deliver better pricing management against the demands of consumers.

Key Findings:

  • Nearly 25% are not pursuing organizational efforts to provide more price transparency for patients and families
  • Less than 50% respond to consumers’ requests for price quotes within a defined time period
  • Only 10% of organizations list prices online.

Mike Peluso, CTO with Rectangle Health, wrote an article about making “healthcare commerce” into a user-friendly experience. He says: “Studies show that nearly 75% of insured consumers are willing to pay up to $1,000 in out-of-pocket medical expenses each year and 25% would be willing to pay bills up to $200 at the point of service if they have been given a good faith estimate in advance of the service. Hospitals must be more focused on satisfying the modern patient by not only providing excellent care, but also by offering efficient and user-friendly payment options.”[5]

People want to shop for their healthcare services. They are willing to pay, even at the time of service. But they want to know how much it’s going to cost. And they can’t get a straight answer! The industry is not responding to consumerism in healthcare. At the conference, we spoke with a medical doctor who also has a J.D. She said her own organization couldn’t give her accurate pricing for her parents.

We are truly mystified as to why this industry refuses to treat people like consumers. The Becker’s conference opened our eyes to the fact that the industry is not waking up. Nothing of substance is being said or done about price transparency and consumerism. Hospitals are suffering financially. Moody’s has said they are on a course that is unsustainable. Many are filing bankruptcy or closing altogether. When you add to that the fact that companies like Amazon and Apple are fed up with out-of-control costs and creating their own clinics, healthcare has a serious, serious situation.

What few solutions are being used today only give estimates. No one shops based upon an estimate. So when people say that patients don’t want to shop for their healthcare, it’s because they don’t have any way to shop. If you don’t know the price until after the fact, you can’t control costs. There is no excuse to keep treating people like this. People vote with their feet and they are creating their own clinics in their workplaces.

The answer is simple: Consumerism in healthcare needs to be the Amazon experience.

A solution exists to give people the Amazon experience in healthcare and it’s ready to be implemented today. HealthQRS provides people a full retail experience in healthcare just like they are used to receiving from Amazon for retail goods. From their smartphones, consumers can search for services and procedures in their network, see true prices – not just estimates – schedule the service, search for discounts, pay for the service or set up payment plans, find transportation, receive appointment alerts, wellness alerts, and even see a doctor via telemedicine. You name it. We offer it.

HealthQRS provides providers with the infrastructure to create an online experience for consumers including accurate pricing (not just estimates). We allow you to easily bundle prices so there’s no surprise billing. 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.

HealthQRS is the perfect vertical application for integrated delivery networks. We provide regulation compliance and serve as a marketing tool for your facilities. In addition, HealthQRS allows you to be compliant with the new CMS transparency rules beginning Jan. 1, 2019.

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? Embrace consumerism today.

###

[1] Alia Paavola, “Here’s why Amazon and Apple are betting on medical clinics,” Becker’s Hospital Review, Sept. 10, 2018, https://www.beckershospitalreview.com/facilities-management/here-s-why-amazon-and-apple-are-betting-on-medical-clinics.html

[2] Paavola, “Here’s why Amazon and Apple,” https://www.beckershospitalreview.com/facilities-management/here-s-why-amazon-and-apple-are-betting-on-medical-clinics.html

[3] Paul Crnkovich, et al, “2018 State of Consumerism in Healthcare,” 2018, Kaufman, Hall & Associates, LLC, https://www.kaufmanhall.com/sites/default/files/2018-State-of-Consumerism-Healthcare.pdf

[4] Lisa Skriver, “Healthcare Consumerism: The Disconnect Between Knowing What Needs to Change and Putting a Strategy in Place to Get There,” Aug. 24, 2018, MediRevv, https://www.medirevv.com/blog/healthcare-consumerism-the-disconnect-between-knowing-what-needs-to-change-and-putting-a-strategy-in-place-to-get-there

[5] Mike Peluso, “Healthcare Commerce as a User-Friendly Experience,” Rectangle Health, https://cdn2.hubspot.net/hubfs/498900/Rectangle_WP_July2018.pdf