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Healthcare Providers Concerned, Unsure How to Address CMS Price Transparency Final Rule

CMS Price Transparency Market Report

Highlights 

  • Recent survey shows 92% healthcare providers are either “somewhat” or “very” concerned about how their charges will be perceived by the public

 

  • 43% of healthcare providers don’t yet know how they will address the CMS mandate

 

  • Only 29% of healthcare providers recognize the need to post additional pricing information in addition to the standard chargemaster

 


 

Summary

Almost all healthcare providers (92%) are concerned to some degree about how their charges will be perceived by the public in response to the CMS Price Transparency Final Rule, according to a recent survey of 150 healthcare participants on a recent webinar with PMMC and HBI (Healthcare Business Insights). The participants varied in size ranging from hospitals with 100 acute care beds to multi-facility healthcare systems.

The webinar addressed the frequently asked questions (FAQ’s) from the CMS Price Transparency Final Rule, highlighting the fact that hospitals must post standard charges online for any given service in a machine-readable format.

 

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However, there is growing concern about how much value this really provides for patients and the potential perception problem it creates for hospitals.

Despite the January 1, 2019 deadline for the rule, 43% of healthcare providers responded that they don’t know yet how they will address the mandate. 29% said they plan to post additional pricing information beyond the chargemaster, while 22% said they would post chargemaster prices only.

 

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“We all know this requirement is not going to necessarily help a patient price shop,” said Tara Bogart, Vice President of Consulting at PMMC. “It may help them a little bit but it’s not the perfect answer.”

Despite the vague guidelines provided by CMS, it’s become apparent that the agency is pushing the healthcare industry towards a retail-like model to help consumers price shop for healthcare services.

“If you’re buying a car or pretty much anything else, you’re able to do some research. You’re able to know what the quality is. You’re able to make comparisons. Why shouldn’t we be able to do that in healthcare? Every healthcare consumer wants that,” says Seema Verma, CMS Administrator.

 

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Meanwhile, patients are price shopping online today more than ever before. According to the 2018 UnitedHealthcare Consumer Sentiment Survey, more than one-third of respondents (36%) said they have used the internet or mobile apps during the past year to compare the quality and cost of medical services. This is almost triple the amount since 2012, when only 14% of patients were price shopping.

Additionally, 1 in 10 patients said they would actually switch healthcare providers after price shopping (UnitedHealthcare Consumer Sentiment Survey).

Because patients rarely pay the full listed chargemaster price, hospitals posting just the standard chargemaster run the risk of misleading patients into inaccurate pricing.

That’s why it’s important for hospitals to consider a more strategic approach when posting the chargemaster and making it easier for patients to price shop by presenting a personalized cost of care. This allows the hospital to control the price message and will prevent patients from potentially visiting a different provider in favor of a better price.


Learn More on Upcoming Webinars

To learn more about the CMS price transparency rule and how to control the pricing message, register for one of our upcoming webinars:


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