Lessons Learned from Price Transparency Pioneers
“For price information to be meaningful to patients, it should focus on a patient’s financial obligation—what that individual is expected to pay—and not merely charges,” says HFMA President and CEO Joseph J. Fifer, FHFMA, CPA. This is a lesson that Fifer learned first-hand in his former role as vice president-hospital finance at Spectrum Health. In 2007, Spectrum was one of the first health systems to provide detailed out-of-pocket cost estimates to patients, in addition to posting gross charges and average payments on its website.
That same year, Alegent Creighton Health, a 10-hospital system based in Omaha, launched its MyCost online tool, which allows patients to obtain the estimated total cost—and their out-of-pocket responsibilities—for nearly 700 procedures.
These are the types of meaningful price transparency efforts that can gain the trust of consumers and help patients take greater charge of their healthcare purchasing decisions. Both of these goals have been advocated by HFMA’s Patient Friendly Billing® project for years.
Improving Cancer Care Value: UnitedHealthcare’s Episode-Based Payment Pilot
New cancer drugs, some of which cost $5,000 or more a month, may extend life only a few weeks; yet, current payment systems encourage their use. The UnitedHealthcare pilot, which started in 2010, seeks to escape the “buy-and-bill” system, which encourages oncologists to select the most expensive drugs and discourages the use of low-cost generics.
The pilot in five oncology practices uses an episode-of-care payment strategy for physicians. Each oncology group chooses the treatment regimen it wishes to use (e.g., a certain drug at a certain dose, additional drugs for side effects) for 19 specific cancer scenarios. The physicians then commit to at least 85 percent compliance with the chosen therapy.
ACO Pioneers Enter the Payer Market
Two of the first accredited accountable care organizations (ACOs) are collaborating with payers and employers to leverage quality and efficiency in health care. These large multispecialty group practices—Crystal Run Healthcare and Kelsey-Seybold Clinic—are tapping the employer self-insurance market to assist companies with rising costs as the Affordable Care Act expands coverage to more people.
Humanizing Health Care to Boost Patient Satisfaction
At Twin Rivers Regional Medical Center, nurses ask patients about their fears and concerns during the admission process. That human connection has helped Twin Rivers increase patient satisfaction scores by 33 percent last year. Added benefits: employee job satisfaction is on the rise and physician loyalty is increasing.
Deloitte: Realizing the Potential of Your CDI Program
Suzanne Whitworth, director at Deloitte & Touche LLP, and LaVerne Romberger, MSN, CCM, CCDS, clinical operations manager-Seton Healthcare, share leading practices for maximizing the potential of clinical documentation programs under value-based care.
RevSpring: Customizing a Technology Platform to Drive Patient Payment
Martin Callahan, Senior Vice President, Healthcare Solutions, RevSpring, describes key industry trends affecting how patients engage with the revenue cycle and ways payment processes are changing as a result.
KPMG: Readying for Healthcare Today and Tomorrow
Dion Sheidy, a partner in KPMG's Healthcare Advisory practice, discusses healthcare's changing landscape and how having the right advisor can help organizations navigate challenges and opportunities.
Huron Healthcare: Readying Your Organization for Transformation
Gordon Mountford, executive vice president, Huron Healthcare, discusses business imperatives for undertaking transformative change.
Xtend Healthcare: A Custom Approach to Optimizing Revenue Cycle Performance
Tom O'Neill, CEO of Xtend Healthcare Advanced Revenue Solutions, discusses key areas where organizations risk revenue leakage and ways they can use outsourcing to better protect cash flow and support accurate payment.
KeyBank: Helping You to Realize Your Strategic Vision in Changing Times
Victoria Terekhova, senior strategist for Enterprise Healthcare at KeyBank, discusses key challenges when developing long-term strategy in a rapidly changing industry, and the role the right banking partner can play in helping healthcare providers navigate the opportunities before them.
SSI: Preparing the Revenue Cycle for Changing Payer Roles
Availity: Connect to the Future of Healthcare Information
Deloitte: Leveraging IT for Value-Based Care Transformation