On Demand Webinar | Basic | Patient Financial Communications
This session will involve first-hand observations about today's consumer financial decision-making trends and explore insights from a recent survey of over 2,000 U.S. adults who visited a doctor or healthcare facility within the past year f...
Save
On Demand Webinar | Overview | Patient Financial Communications
Health care professionals need to understand that the rules governing health information are changing.  Under current final rules, providers and health plans must share data directly with patients, and if a patient requests their data ...
Save
Course | Intermediate | Patient Financial Communications
In this course we will address the Patient Financial Communications Best Practices through concepts of financial counseling. We'll review patient financial care concepts, which include negotiating account resolution, identifying and initiat...
Save
Course | Basic | Patient Financial Communications
HFMA's Patient Financial Communications Training Program is an online toolkit that provides revenue cycle staff with guidance for conducting sensitive financial conversations with patients. It shows patient access professionals how to commu...
Save
Course | Basic | Patient Financial Communications
HFMA's Patient Financial Communications Training Program is an online toolkit that provides revenue cycle staff with guidance for conducting sensitive financial conversations with patients in the emergency department. It shows patient acces...
Save
Column | Patient Financial Communications

Price Transparency: The View from Washington

Column | Patient Financial Communications

Price Transparency: The View from Washington

HFMA President and CEO Joe Fifer discusses implications of a new federal report that addresses price transparency.

A new federal report on the future of our healthcare system focuses on price transparency—and signals that big changes may be ahead.

Among the most encouraging signs in Reforming America’s Healthcare System Through Choice and Competition is recognition of a key tenet of HFMA’s price transparency work: Personalized out-of-pocket prices are much more useful to patients than “relatively meaningless charges,” as the report characterizes chargemaster prices. However, there is no indication in the report, which was prepared by HHS in collaboration with other federal agencies, that CMS plans to drop the new requirement for hospitals to publish chargemaster prices online in machine readable format. This is unfortunate, because publishing these data does little or nothing to help patients understand their financial responsibility or manage their out-of-pocket expenses.

The report also recommends that the administration encourage the private sector and states to build consumer-friendly websites capable of displaying price information for the most common transactions. HFMA has long recommended that providers focus on the services they deliver most often rather than trying to price out the entire repertoire of procedures they perform. State websites like Maryland’s “Wear the Cost” embody this approach by focusing on common, shoppable services such as childbirth, hysterectomies, and joint replacements. The administration is likely to release more pricing tools for Medicare patients, like the one it released for outpatient surgeries. Moreover, CMS likely will see voluntary efforts to create consumer-friendly price and quality transparency websites as contributing to improved price transparency in the industry, another tenet of HFMA’s Patient Financial Communications Best Practices.

The report also states that Congress should seek to empower patients as they shop for health care by making it easier for them to pay for it directly. For example, all Americans—not just those enrolled in high-deductible health plans—could potentially be allowed to maintain health savings accounts. The report goes on to recommend that federal agencies eliminate any federal rules or policies that create unnecessary barriers to state, federal, or private sector initiatives that provide price transparency. It’s easy to agree, in principle, with that recommendation.

But the Trump administration may have bigger things in mind. For example, citing places where consumers can get lower cash prices for select services than third-party payers can, the report suggests that “further development of a consumer market for health care, anchored around readily available healthcare prices, will likely require reforms to the third party payment system.”

Bottom line: This administration supports price transparency and consumer empowerment—and they are not ruling out a legislative or regulatory approach to achieving those goals. The implications for providers are straightforward. First, make improving price transparency a priority for your organization. Recent remarks by both HHS Secretary Azar and CMS Administrator Verma have made it clear that price transparency is a priority for this administration. Second, monitor consumer-focused developments in Washington closely. An easy way to do that is to follow HFMA’s news coverage. In an era of uncertainty, you can be sure that consumerism will continue to be a priority for HFMA.

About the Author

Joseph J. Fifer, FHFMA, CPA,

is President and CEO of HFMA.

Advertisements

Related Articles | Patient Financial Communications

Trendsetter | Self-Payment Collection

Offering long-term payment plans to meet the financial needs of patients

A forward-thinking bank talks about its accessible patient finance program, which gives patients a way to afford care while ensuring timely payment for healthcare organizations.

News | Revenue Cycle

HFMA’s Digital Revenue Cycle Conference Sept. 30 and Oct. 2 will focus on how healthcare providers can build a consumerism strategy and use consumer-centric KPIs

HFMA's Digital Revenue Cycle Conference features 20 presenters during live sessions, the ability to earn CPE credits and time for networking and peer-engagement.

News | Coronavirus

Why it's imperative for healthcare organizations to review their financial assistance programs during the COVID-19 pandemic

Revenue cycle management services executives discuss why healthcare organizations should review their financial assistance programs amid the COVID-19 pandemic.

How To | Financial Leadership

3 keys for hospitals seeking to establish a work-from-home setup for patient financial services

During a six-year process to move its Patient Financial Services department to a full-time work-from-home setup, Spectrum Health learned key lessons and best practices.