Recognizing that its billing and collections process was negatively affecting patients' health care experience—and thus patients' likelihood to return for future care and recommend the hospital to friends and family—CHOP took a unique approach to offering price transparency.
Here's how CHOP's recently implemented Price Cost Estimation (PCE) department reduced complaints on unexpected charges and improved patient satisfaction for its imaging services.
The price transparency challenge
It's no secret that consumers are increasingly factoring cost into their health care decisions: a 2016 Accenture survey found that 91% of consumers wanted to know their out-of-pocket costs before receiving care. But CHOP knew that many organizations struggle to respond to consumers' transparency demands. In fact, 63% of health care executives, practice administrators, and billing managers identified price transparency as a challenge in 2016, with 42% identifying accurate price estimation for services as a top barrier. The survey found major gaps in the availability of patient-facing cost-estimation tools and staff trained and available for answering pricing questions.
CHOP's PCE department provides meaningful estimates
CHOP solved this problem by creating a Price Cost Estimation department and staffing it with four full-time benefit specialists. Additionally, CHOP took a proactive approach to promoting its price estimation services. Radiology department schedulers provide information about the price estimation service at the time of outpatient scheduling, and if the patient requests a price estimate, schedulers directly transfer the call to the benefit specialists. CHOP's patient portal and referring physicians' offices also promote the PCE department.
While four FTEs is a significant investment to make in price transparency, CHOP's efforts seem to have paid off: The PCE department reduced complaints of unexpected costs by 63% and improved patient satisfaction by 85% over the last year.
This effort has likely had a positive effect not only on current patients' and families' experiences, but also their loyalty to CHOP and their likelihood to recommend the provider, as well as on new patient acquisition efforts.
Next steps on meeting price transparency needs
With CMS' price listing mandate nearing effect, provider organizations will be scrambling to post their "standard charges" online. Progressive providers such as CHOP will go a step further, however, and offer customized and more meaningful estimates for patients.
While a dedicated price transparency team like CHOP's may be a worthwhile investment for select systems, others may be able to take a less resource-intense approach and still see benefits. Here are some suggestions for imaging leaders and others in "shoppable" departments who are interested in establishing or improving price estimation services:
- Train radiology billing staff in financial counseling and how to use price estimation software;
- Understand how price estimation works in your department—how price estimates are given, the frequency of price estimate requests, and the nature of patients' responses;
- Designate specific individuals who are allowed to give estimates, so that consumers do not get conflicting estimates for the same service;
- Consider investing in an online price estimate calculator that can consider a patient's insurance and deductible to offer a personalized quote; and
- Regularly monitor the accuracy of price estimation procedures by testing price estimates in a pilot. In these cases, out-of-pocket estimates are generated but not given to patients. After the patient attends the visit, the actual price paid by the patient is compared to the estimate.