Why a price transparency tool isn't just 'nice'—it's necessary

Why a price transparency tool isn't just 'nice'—it's necessary

By Sam Bernstein, Senior Staff Writer

Health care price transparency is no longer just over the horizon—it's here. States like Ohio and Florida are mandating that health care providers offer price estimates to any patient who asks, and President-elect Donald Trump has said that price transparency will be part of his health care agenda.

And while the Affordable Care Act's (ACA) future remains uncertain, the explosive growth of high-deductible health plans and the need for providers to become more consumer-focused will persist no matter what happens with the ACA. "There's now this undeniable rising tide where, in the next year or two, every organization across the country has got to be putting a price transparency strategy and solutions in place," Advisory Board Managing Director Jim Lazarus tells the Daily Briefing.

Some already are. The Daily Briefing recently covered how Ohio-based ProMedica partnered with Advisory Board and several health systems—including BJC HealthcareCarolinas Healthcare System, and Baylor Scott & White Health—to hone its price transparency strategy.

How Advocate, ProMedica, and other health systems are tackling price transparency

ProMedica now offers an online tool to help patients calculate out-of-pocket cost estimates in real time. Patients input their name, insurance company, and policy ID number to receive a price estimate for lab, surgery, and radiology services.

Giving patients certainty

ProMedica's approach is different than what many patients will find online when they search for price information. Many websites now claim to offer estimates of out-of-pocket costs, but the varying and often misleading information leaves patients frustrated and more uncertain than when they started, Lazarus says. 

"Existing sites either rely on outdated and (sometimes wildly) inaccurate information or give patients a wide range for out-of-pocket costs, which are, by definition, inaccurate," Lazarus says. "Patients need to know exactly what a service will cost them for their situation—and the only entity that can give a patient a fully accurate estimate is the provider who is going to deliver that care."

And for providers, getting accurate pricing information in patients' hands can pay dividends in revenue capture, bad debt reduction, market share, and patient satisfaction. According to Advisory Board research, a four-hospital system can see swings in revenue of $16 million to $40 million due to its price transparency strategy—or lack thereof.

A 'no regrets' investment

Lazarus says investing in price transparency is a "no-regrets" improvement that caters to consumers' expectations. First movers, he explained, will have an advantage over their competitors. "Providers who are not embracing this approach and not deploying these tools are likely to see increased frustration from patients, reductions in share, and are going to be unsuccessful in successfully capturing rising patient obligations," Lazarus says.

"Price transparency is not merely a 'nice' thing to pursue," Lazarus adds. "It is a necessary thing to embrace in order to succeed in today's environment."

Next steps: Preview Advisory Board's new consumer-facing pricing tool

In response to patients' and providers' demand for consumer-facing price transparency tools, Advisory Board has developed the Price Transparency Compass, which provides on-demand and accurate estimates for patients in less than two minutes—and without confusing health care jargon.

Price Transparency Compass pulls data from several sources to deliver the information patients need in real time. "You need to have all this information come together in a matter of seconds to successfully calculate the accurate amount the patient will owe out of pocket," Lazarus observed.

Join Lazarus for a webconference on Thursday, November 17 at 3 p.m. ET to preview the new tool and learn how it could help your organization.

Register now


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