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.

###

[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

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.

###

[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

 

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.

 

Focus on providing your patients with the Amazon experience and change your fortunes

by admin 0 Comments

Every now and then a remarkable article is published. One that “gets it,” that captures and explains current issues succinctly and perfectly. Rebecca Pifer, associate editor for HealthCareDive (with Tony Abraham contributing) did just that in her article, “Consumerism (and Amazon) loom over #USNHoT,” published November 20, 2018. Pifer’s article is spot on in identifying the key areas of focus recommended for hospitals to improve volume and revenues. We recommend that you read it in its entirety if you want to fully grasp what the patient/consumer expects from today’s healthcare experience. And interestingly, HealthQRS has the solution to every major point in the article.

Pifer jumps right into the healthcare executive’s big fear today: the fact that Amazon is at the center of healthcare disruption and its tentacles touch almost every aspect of healthcare. She quotes Aaron Martin, EVP and chief digital officer of Providence St. Joseph Health, who spoke at the U.S. News & World Report Health of Tomorrow (USNHoT) conference: “American healthcare is currently in the same spot as the publishing industry was in 1997, when Amazon disrupted the book value chain.”[1]

At the heart of healthcare’s issues is consumerism. The fact that Amazon has perfected how to exceed consumer demands is what has made the company the global giant that it is. Hospitals who adopt Amazon’s methods in reaching consumers will attract and keep them. And HealthQRS can help you do just that in a simple, timely manner.

Pifer’s shares three main points about how to win consumers, with hospital executives weighing in on each:[2]

  1. Engagement, immediacy and convenience

The healthcare industry is really no different from the airline industry, according to Manny Rodriguez, chief marketing and experience officer at provider network UCHealth. Rodriguez says the whole idea is to get from point A (your location: unhealthy) to point B (your destination: healthy) as safely and pain-free as possible. What our patients really want is this notion of immediacy – like Netflix. What people are looking for in consumerism is convenience and, though this may be unrealistic, that’s what they want.

HealthQRS takeaway:

HealthQRS’ tagline is “Where better health takes flight.” We chose this tagline because our solution is like the Expedia of healthcare. HealthQRS’ solution allows you to provide people with a true retail experience in healthcare. We give consumers a site that allows them to shop, schedule and pay for services and medications and see actual pricing and options based on their health plans and networks. 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 the provider’s 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 has developed the only complete e-commerce platform for healthcare on the market. 

  1. A focus on the consumer starts with a focus on data and IT

Larry Hollier, surgeon-in-chief, Texas Children’s Hospitals says that as healthcare attempts to become more patient-centric, it’s key that health systems meet consumers in their comfort zone: online. People like to review an interaction before they have it. Texas Children’s used to find misleading information about its practices on Google provider sites. Now, it manages roughly 750 websites, standardizing content and inserting widgets to bring customers straight into the hospital’s online scheduling process.

HealthQRS takeaway:

It’s great that Texas Children’s is bringing customers straight into its online scheduling process. But managing 750 websites? HealthQRS’ one solution would streamline this process for Texas Children’s and allow its patients to not only schedule appointments online, but to pay for them and even arrange transportation, all from the app. And if the patient is too busy or remote to get to one of their locations? 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.

HealthQRS is the perfect vertical application for integrated delivery networks and we can set you up with a complete, online retail site right now.

  1. Branding and ongoing relationships are a must

Adventist Health System is changing its name to AdventHealth in January as it works on internally aligning its system around the patient. Marcela Reyes, director of patient experience with Adventist Health System says that Adventist is here to build relationships for a patient’s whole life cycle.

Adventist saw its patient payment volume more than double between the second quarter of 2017 and the same quarter this year by revamping its billing process to be more consumer-friendly and price transparent.

HealthQRS takeaway:

People will flock to a healthcare provider that gives them a great customer experience. Our solution helps you do that on so many levels. People want to know what healthcare is going to cost them. With our solution, you can show them their actual out-of-pocket expenses. Our system helps consumers schedule their services and pay at the time of scheduling. If they can’t pay the full amount, they can make payments, depending on the business rules that you choose. They can easily find services and procedures and they know that they will always be in-network when they shop via HealthQRS. Our point-of-service module provides interactive scripts for your registrars and schedulers to help them have fruitful financial conversations with patients. Our scripts and solution allow your staff to actually give answers to people about their out-of-pocket instead of saying: “I don’t know.” Or, “I have no way of knowing that information.”

We provide price transparency regulation compliance, and this serves 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 and beyond that.

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.

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?

###

[1] Rebecca Pifer, “Consumerism (and Amazon) loom over #USNHoT,” HealthCareDive, Nov. 20, 2018, https://www.healthcaredive.com/news/consumerism-and-amazon-loom-over-usnhot/542609/

[2] Pifer, “Consumerism,” https://www.healthcaredive.com/news/consumerism-and-amazon-loom-over-usnhot/542609/

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

 

Healthcare execs admit they are doing so-so with patient billing. Are their hospitals going the way of Blockbuster?

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Hospital executives admit that they have issues and not doing a good job of billing, but they say billing and payments are of highest priority. Yet Moody’s recently reported that hospitals are on an unsustainable financial path. To call this a dichotomy would be an understatement in all caps. Hospitals must change the way they do business or they simply won’t survive. And first and foremost, they need to adopt a consumer’s approach to healthcare.

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/