CMS is Pushing Hard for Price Transparency

Here are three ways providers can make prices meaningful for patients.

By Jason Considine

Senior Vice President & General Manager, Patient Access, Collections, & Engagement Experian Health

The recent Executive Order on price transparency won’t give consumers a better understanding of how much they will owe for their healthcare services, but it remains clear that successful patient collections are becoming more reliant on up-front, transparent out-of-pocket costs for consumers.  

When patients know what to expect in their bills, everyone benefits. The payoff for providers comes in the form of efficiency savings and improved collections, as fewer patients delay care and more meet their obligations. Consumers feel better about having more choice and control over their care (and their costs). 

Improving the consumer experience includes transparent pricing 

That said, think about it from your own healthcare setting. Look at your patient feedback. Chances are, your consumers’ pain points aren’t limited to the bedside care they received. Even when they’ve had a positive experience within the hospital setting, many patients may report confusion, anger and stress as soon as they try to manage the billing side of things.  Also, look at the medical debt numbers in America today. The entire industry feels the pinch of unpaid bills at some level, and the rate of debt is not slowing down. 

When patients don’t get the care they so desperately need or fall into hard times that can affect their recovery because of the costs, we must act. Frankly, it’s no surprise that healthcare consumers would welcome a more transparent and streamlined process. They know their costs upfront in almost every other environment so they’re increasingly expecting the same personalized experience in healthcare. But that shouldn’t be our only impetus to make change. Americans deserve a holistic and caring healthcare experience that takes into account the entire journey so that they can get the care they need and be able to meet their obligations. 

The industry has certainly made great strides in personalizing the patient experience over the last decade. But ultimately, that transformation is incomplete without an overhaul of the financial experience as well. This includes addressing the patient experience from start-to-finish including offering modern, online and mobile-optimized tools to ensuring data and pricing is accurate, and providing payment options such as charity support and payment plans to help consumers manage costs. 

Embrace technology as the path forward

The bright light – no matter where legislation falls – is that there is technology available to make engaging in price transparency a seamless reality for healthcare organizations. 

For providers looking to stabilize their revenue cycle and offer a more consumer-centric experience, there are several proven ways to harness data and technology to give patients financial clarity:

1. Provide price estimates 

As many as 90% of patients admit to significantly underestimating the cost of treatment, according to Experian research. Generating accurate estimates based on treatment costs, payer rates, and the patient’s eligibility for financial support lets patients know what to expect so they can plan accordingly. This kind of approach helped our client Saratoga Hospital increase cash collections by 400% in just three years, as patients were able to make quick, informed decisions about their care before even setting foot in the hospital.

2. Simplify bills 

Overly complex bills and statements can lead patients to delay payment while they try to figure out what it all means. Consider a software solution that combines all of the patients billing elements into one simple statement. For a patient engagement win, you can also incorporate relevant and personalized messages and resources to help patients access other health improvement services.

3. Self-service portals empower patients

One area where healthcare can learn from other consumer-facing industries is in the use of digital, self-service portals. Consumers are used to managing other aspects of life online, so why not health? Make it easy for them to access estimates, pay their bills and manage their healthcare journey with a secure online portal.

We’re amid a transformation in healthcare. Mandated or not, there’s no doubt that a responsive and transparent patient financial experience will give providers a competitive edge, boost patient outcomes and improve population health. Those that recognize the opportunity in this latest transformation will thrive. The good news is that the tools exist to support you in leveraging proactive, flexible and upfront financial solutions for your consumers.