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

 

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.

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[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

 

Experian study reveals that 98 percent of consumers worry about covering healthcare costs

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An 85-year-old man named Bob had a total knee replacement just this week to help him deal with pain he’d had for 60 years due to a college football injury. Bob has Medicare as well as a Medicare Part D supplement. One of his sons accompanied him on his visit to the surgeon. When Bob asked how much the knee replacement would cost, the surgeon told him not to worry, that his insurance would cover it. Later, at the hospital, during pre-admission testing, a second son decided they should speak with financial counselors to get some idea of the surgery’s cost. “Well, our codes don’t really match the codes at Medicare, so I can’t really give you a true cost. I can ballpark it for you,” said the financial counselor. She reached out to her manager, had about a 10-minute discussion and came back. “I think it’s going to be somewhere around $2,400,” she told Bob and his son. They asked if this was just for the hospital bill. “Oh yes,” came the answer. “We have no idea what the surgeon’s or the anesthesiologist’s bills will be.” Then when told that Bob had a Medicare supplement, he was told they wouldn’t even be able to provide information about the hospital’s bill before the surgery. “But we have financial programs available to help you after the fact,” said the registrar.

This is a major IDN that uses one of the top EHR systems in the country. And they couldn’t tell Bob or his son what the costs of his surgery would be.

Now Bob is a conscientious gentleman and doesn’t leave any bill unpaid. In fact, when he gave his wallet to his son for safekeeping just before surgery, he told him that he had a blank check in there to pay for the hospital bill upon his discharge. But the reality? He won’t find out the true cost for the many services surrounding his knee replacement until he gets the bills about 60 days later. And it won’t be just one bill. He’ll get a bill from the hospital. From the surgeon. From the anesthesiologist. From the lab. And the list goes on.

True story. Happened in Louisville, Kentucky, but could have happened anywhere in America, because it does. Every day.

As this 85-year-old man undergoes a painful recovery, he will also be worrying about his medical bills.

And he’s not alone. A recent health study by Experian, that included a survey of more than 1,000 U.S. healthcare consumers, revealed the breadth of financial issues for healthcare consumers. One of the biggies? Almost all of the respondents (98 percent) ranked concerns about being able to cover out-of-pocket costs as a “very” to “extremely” important pain point during their healthcare journey.[1] Let’s look at the statistics from the study: [2]

  • 33% of consumers said they worried about determining their out-of-pocket costs versus what their health plan covers
  • 32% said they used the internet of mobile apps in the last 12 months to shop around for care
  • 28% said they worried about being ble to pay for medical tests recommended by their provider
  • 90% significantly underestimated costs related to major medical procedures, such as a knee replacement
  • 98% ranked concerns about being able to cover out-of-pocket costs as a “very” to “extremely” important pain point during their healthcare journey.

Think for a moment, about the increased stress levels of people worrying about their out-of-pocket medical expenses, which in the Experian study, is almost 100% of people. The American Institute of Stress says that stress can cause numerous emotional and physical disorders “including depression, anxiety, heart attacks, stroke, hypertension, immune system disturbances that increase susceptibility to infections, a host of viral linked disorders ranging from the common cold and herpes to AIDS and certain cancers, as well as autoimmune diseases like rheumatoid arthritis and multiple sclerosis.”[3] And that is just the tip of the iceberg. The American Institute of Stress goes on to say: “In fact, it’s hard to think of any disease in which stress cannot play an aggravating role or any part of the body that is not affected.”[4]

We have spoken with many large corporations who are tired of seeing their employees suffer from the stress surrounding medical bills, and especially the fact that they can’t figure out what their bills are going to be beforehand. They have told us repeatedly that they don’t want their employees forced to deal with provider portals because portals don’t provide meaningful information. These portals are piecemeal at best and only give estimates. They are not providing the users a good experience. They are looking for the Amazon experience in healthcare.

HealthQRS has developed an entire, seamless platform that can fully and easily integrate into EHRs to provide the retail experience that these EHRs do not offer. (And it’s not a portal because employers don’t want their employees to be forced into portals.) Our solution provides people a full retail experience in healthcare just like they are used to receiving from Amazon for retail goods. Because we are integrated with your EHR, you get the full benefit of reporting analytics which will improve your meaningful use numbers and increase meaningful use funds. We also have a point-of-service application that allows your registrars and financial counselors to answer consumer’s questions about financial responsibility in person or over the phone.

We provide accurate, true pricing (not estimates) for the entire procedure. 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. Our technology enables people to connect to more cost-effective, consumer-oriented healthcare options and we keep them in-network.

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? Follow the money and it will lead you to consumers. We can help you help the Bobs of the world, win them and keep them.

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[1] Kelly Gooch, “Financing their healthcare a big pain for many consumers, survey finds,” Becker’s Hospital Review, Sept. 5, 2018, https://www.beckershospitalreview.com/finance/financing-their-healthcare-a-big-pain-for-many-consumers-survey-finds.html

[2] Gooch, “Financing” https://www.beckershospitalreview.com/finance/financing-their-healthcare-a-big-pain-for-many-consumers-survey-finds.html

[3] American Institute of Stress, https://www.stress.org/stress-effects/

[4] American Institute of Stress, https://www.stress.org/stress-effects/

Kaiser report finds 20% of inpatient billing includes out-of-network charges. Do companies like GM and Disney realize this?

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These days it’s hard to know when you’re in- or out-of-network, even when you are admitted to the hospital via the ER in a hospital that is supposedly in your network. Wouldn’t it be nice if there was a win-win solution to keep people in-network when they are inpatient for any treatment? Wouldn’t it be nice if employers, employees and providers could benefit? Surprise billing is hard on everyone. Providers are trying to help with patient portals, but portals do not offer the infrastructure that a complete e-commerce solution provides.

Providers must learn from Amazon for consumerism to take hold in healthcare

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While hospitals are planning consumerism efforts, they are losing market share to the innovators who are already providing people satisfying experiences with convenience and lower costs. Amazon is the leader in customer experience. With continued innovation and disruption, the retail giant has proven again and again that those who remain in the status quo will lose. Providers who are slow to innovate and disrupt current business models will undoubtedly lose market share and possibly go the way of previous hospitals who have been forced into bankruptcy and closure.

Becoming a Center of Excellence for companies like Walmart

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Imagine if your hospital was the provider of choice for Walmart’s employees. Or any self-insured corporation. Think of the many benefits to employers and their employees (your consumers) plus increased business and revenue that would generate for you. Becoming a center of excellence will provide you with increased volume, which, will in turn, allow you to offer lower prices. This is a win for you, the employer and the consumer.