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

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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.

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[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

 

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.

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[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

 

Trump administration’s short-term health plans open doors for more consumerism

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People are about to have more choices in buying health insurance than ever before. Health and Human Services has issued a final rule that extends short-term, limited duration health insurance plans to a maximum duration of one year. Adapt quickly and market yourself to consumers, to the association plans as well as the self-insured companies. This will help you compete and gain the most market share.

Does Apple Realize Money – Not Wellness – Motivates Consumers?

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Apple is entering the healthcare market and they’re poised to impact it in a huge way if they take a few necessary steps to address financial ramifications for consumers. If Apple pulls e-commerce into the mix they’ll have a complete package to tackle wellness to chronic illness and everything in between, with interoperability between providers and providers and providers and patients. An e-commerce solution from HealthQRS will pull it all together and Apple will be a key player in the largest consumer market in the world.

Apple’s Home Pod and High Deductible Health Plans

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Imagine the possibilities for Apple, Amazon or Google if they choose to partner with HealthQRS to provide consumers private, HIPAA-compliant voice commands in healthcare shopping. HealthQRS’ uniquely disruptive technology is ready. We’ve built a platform that anyone can use to create an online medical marketplace. For instance, Apple, Amazon or Google could use HealthQRS’ system to open up a voice-activated medical marketplace for their customers and literally create the largest online medical market in the world.

Is Facebook Positioned to Change the Medical Market?

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Consumers forced to take healthcare into their own hands are disrupting the healthcare status quo permanently. Companies like Facebook, Apple and Google offer an accessibility for people to reach each other in an unprecedented way. This not only opens channels for world-wide communication, but also for commerce. HealthQRS can help you establish an e-commerce retail solution that will attract consumers and push them to your “storefronts,” i.e., your hospitals, clinics and practices and grow your market share.

Use Tesla’s Strategy to Disrupt Your Healthcare Market

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The status quo doesn’t work anymore and you can’t just depend on Medicare and Medicaid. The good news? You don’t have to. An e-commerce strategy from HealthQRS gives you powerful tools to proactively attract commercial consumers and the self-insured business, whether it’s small, medium or large companies.

Flourish with an E-Commerce and Storefront Approach

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Financial losses, decreased patient volume, high debt loads and subsequent staff layoffs are symptoms of organizations’ sluggishness in adopting retail approaches to business. Whether you’re in a small, medium or large market, if you aren’t using both a storefront and an e-commerce approach for consumers to schedule and pay for services, then you’re susceptible to the hospital bankruptcies and closings happening all around the country.

Delivering – Not Just Promising – Price Transparency

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Regardless of healthcare legislation, an open marketplace will allow people easier access to better care. And right now there is no marketplace. There are just captive patients who need healthcare and who have no idea what it’s going to cost. But HealthQRS has developed a solution that can provide a marketplace for your patients.

How to Engage and Keep Your Patients

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In today’s market, if you want consumers to select your services and your facilities, you need to give them reasons to do so. Not only are they shopping price, they’re shopping for better experiences. And that starts with convenience. If you’re competing with a walk-in retail clinic, you better be offering extremely convenient ways for people to find and book with you.