At the Margins

Why price transparency is failing your patients

For many, the new era of price transparency remains maddeningly opaque.

When patients search for the cost of an upcoming procedure, they typically find the average price for the service. Unfortunately, this information fails to reflect the actual patient obligation. This type of inaccurate estimate can decrease volumes and patient satisfaction.

So what do hospitals and health systems need to do to attract increasingly price-sensitive patients? I sat down with the Advisory Board's patient access experts, Cassie Wolfe and Chris Samples, to hear their thoughts on shifting to a truly patient-centric perception of price transparency.

Q: When we talk about price transparency in health care, how are we traditionally thinking about it?

Cassie: By and large, we think about price transparency as it relates to federal and state government regulations to control health care costs. The idea is that if the government requires hospitals and health systems to offer pricing comparisons, it will help control cost. Unfortunately, when patients look online, they're finding the average price for a basic service. This doesn't typically translate to what a patient's obligation will be.

Q: It sounds like you're suggesting that the traditional way we think about price transparency is wrong. So, how should we be thinking about it?

Chris: It's important for our industry to move our thinking from meeting a mandate to becoming truly consumer-centric. As more and more patients become covered as individuals due to the exchanges, being able to access accurate and easy-to-understand pricing information is only going to become more critical.

Cassie: Exactly. However, not all hospitals are currently set up to provide that level of pricing detail. Patients need an understanding of what they will owe, and it needs to be specific to their insurance coverage—both their benefits and the price their insurance carrier has negotiated with the hospital. To do that, hospitals need staff to educate patients, as well as technology to help automate the estimation process. Without these resources, it's tough to get an estimate in the patient's hands before their scheduled day of service.

Q: What's at stake if organizations can't get an estimate out in advance?

Cassie: First and foremost, patient satisfaction is affected. In the past, a lot of organizations were afraid that sharing financial obligation information before the point-of-service would scare patients away. Today, if you can't provide this information upfront, you run the risk of losing patients to competitors who can provide accurate prices estimates.

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Chris: Nowadays, patients can shop around for non-emergent procedure. If you can't stay ahead of—or at least keep pace with—the competition on price, word of mouth, and HCAHPS, and your patients will go elsewhere.

Q: Chris and Cassie, you're both in the trenches with our members, helping them enhance their patient access procedures. What type of advice do you give to members regarding price transparency?

Chris: A lot of organizations are still trying to figure out where to go. We're here to work with members on three fronts: strategy, technology, and training. When it comes to strategy, we sit down with members to help them:

  • Select the right areas in which to be transparent and competitive
  • Assess ideal time to go to market
  • Identify the right groupings of procedures to include

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Once you have the strategy nailed down, it's time to think about leveraging a good price estimate technology and creating very precise scripting and training around collections.

Cassie: Many of our members have already seen significant benefits from providing true price transparency, thanks to strong strategy, technology, and training, as Chris mentioned. Through our patient access technology, we ensure our members have an accurate estimate that has been automatically calculated for them. Beyond the benefit to the patient, automatic calculation helps staff as well. It alleviates the burden by automating what was once a manual and time-consuming process. It's a win-win for patients and staff.

Ready to optimize your patient access process?

As the evolving reimbursement landscape increases patients' financial obligations, your organization is even more at-risk for bad debt and decreased patient satisfaction. Partner with us to support staff and patients through this transition by focusing on critical patient access functions. Contact Cassie or Chris today to learn more.

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