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Guidance for understanding and communicating about the price of health care.
Transformation toward value-based healthcare is reshaping the delivery of care, patient expectations, and payment structures.
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Chicago — April 16, 2014 – A task force made up of healthcare leaders and consumer representatives has reached consensus on how consumers can obtain clear and easy-to-understand information about their financial obligation for healthcare services—before any tests or procedures are performed.
Led by the Healthcare Financial Management Association (HFMA), the task force developed guiding principles and recommendations for price transparency which highlight how hospitals, physicians, and health plans would share reliable information on healthcare prices with consumers. Combined with other relevant information, such as quality and safety, price information will help consumers make more informed healthcare decisions.
"People everywhere want to be smart healthcare consumers, but information about healthcare prices is not easily accessible," said Joseph J. Fifer, FHFMA, CPA, President and CEO of HFMA. "For too long it has been unclear how consumers should go about getting price information—who to ask, what to ask for, or what the information even means when they do receive it. This approach is a game changer."
The task force included representatives from America’s Health Insurance Plans, the American Hospital Association, Catalyst for Payment Reform, Community Health Advisors, and others, including a patient. Working together, stakeholders identified how anyone can receive reliable price information, tailored to insurance status. Participants agreed that patients who are insured should rely on their health plans to provide price information. The task force also agreed that hospitals should serve as the primary price information resource for uninsured patients and those seeking care outside of their insurance network.
"The American Hospital Association has long supported the need to provide patients with healthcare price and quality information," said Rich Umbdenstock, President and CEO of the American Hospital Association. "Hospitals are committed to improving how consumers get information on the amount they will be expected to pay for care."
Stakeholders agreed that consumers should be able to make meaningful comparisons before common elective services with usable price estimates and quality information, enabling consumers to understand the value of the care they will receive. The task force also called on health plans and providers to make price information available in easy-to-understand formats so that consumers can make the most of the information at their disposal.
"Ensuring consumers have the support and information they need to maximize the value of their health care dollars has been a long-standing priority for health plans. These recommendations build on health plans' innovative tools that empower consumers in their decision-making," said Karen Ignagni, President and CEO of America's Health Insurance Plans. "Increased transparency also shines a spotlight on the need for all stakeholders to address the underlying drivers of healthcare costs."
Task force participants said employers can play a role by helping their employees get access to information on price, quality, and cost via appropriate transparency tools. They also called the release of the guiding principles and recommendations a critical step toward greater transparency of price information.
"It’s entirely reasonable for consumers to expect better access to price information," said Fifer. "We are calling on all healthcare stakeholders to acknowledge that and to deliver the clear, reliable price information consumers are looking for. By achieving consensus about the roles all stakeholders should play, we have taken a giant step in the right direction."
Learn more about HFMA's Price Transparency initiative.
With more than 40,000 members, HFMA is the nation's premier membership organization for healthcare finance leaders. HFMA builds and supports coalitions with other healthcare associations and industry groups to achieve consensus on solutions to the challenges the U.S. healthcare system faces today. Working with a broad cross-section of stakeholders, HFMA identifies gaps throughout the healthcare delivery system and bridges them through the establishment and sharing of knowledge and best practices. Our mission is to lead the financial management of health care.
ContactHaydn BushGYMR Public Relations(202) 745-5073
Publication Date: Wednesday, April 16, 2014
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