healow Price Transparency: Promoting Compliance and Savings

How our solution can help hospitals, other providers, and patients

Consumerism can sometimes get a bad name, evoking images of shoppers frantically descending upon the local mall and elbowing past one another to get the latest must-have toy for their kids. But when it comes to healthcare, consumerism is a good thing.

The must-have part hasn’t changed. After all, people seek care either because they are ill or understand the value of preventive screenings and check-ups. But just because people have to be seen by a doctor, there’s no reason to set aside the economic principles that apply to every other marketplace, including clear pricing and a choice of where to get care.

The impact of price transparency rules

Effective January 1, 2021, hospitals and hospital-owned organizations must comply with regulations issued by the Centers for Medicare & Medicaid Services (CMS) that require they post prices for hundreds of “shoppable services.”

How they post those prices matters. The rules require prices be made available in a machine-readable format on an organization’s website, with plain-language descriptions and prompt provision of written estimates for what patients will pay out of pocket for the care they seek.

To help hospitals comply with those CMS rules, we have developed healow Price Transparency. One of our healow account executives, Kimberly Shogren, was recently a guest on the eCW Podcast and explained how, by placing a widget on their website, hospitals can allow their patients to see exactly what their prices are.

Moreover, the healow Price Transparency solution updates price information monthly, helping to ensure organizations remain compliant with federal rules.

“Consumerism is everywhere in our day-to-day lives,” Shogren said. “So, for example, if you were looking to get a ride somewhere, you’re going to call a ride-sharing service, and you’re going to know your exact cost. When you think of healthcare and where healthcare consumerism is going, some of those aspects are already being adopted.”

Promoting competition and cost savings

The initial benefit of healow Price Transparency for hospitals and hospital-owned organizations is gaining access to a tool that fulfills their legal obligations to publish prices. Other providers, including Ambulatory Surgery Centers and other organizations that offer medical services, are not subject to those CMS price disclosure requirements.

For them, healow Price Transparency offers an opportunity to let would-be patients know that they can easily compare prices and perhaps realize savings if they choose to have a given procedure or service provided at a facility other than a hospital.

“The main goals were providing patients with an estimated cost of services and at the same time lowering costs at hospitals by creating a more competitive ecosystem,” Shogren noted.

On the flip side, there is nothing to prevent hospitals from using healow Price Transparency to communicate that their combination of price, availability, and quality for a given procedure may be a healthcare consumer’s best choice.

A healthcare consumer’s perspective

The key for consumers is that healow Price Transparency is both comprehensive and easy to use.

“We are super excited about this solution because for the first time, hospital costs from across the country are all aggregated into one platform,” Shogren said. “This means patients can price shop for those procedures anywhere in the country, and, at the same time, other types of organizations could see if they can find a competitive edge by posting their costs.”

healow Price Transparency lets patients search by area, ZIP Code, and facility. They can input a given radius to find the services they seek in a particular region, perhaps even a place where they plan to vacation. In addition to gaining cost information, patients can use filters to compare any available quality ratings for the facilities and providers they are considering.

A final consideration

The bottom line, Shogren suggests, is simple: Do you want your organization to be ahead of the curve or behind the curve?

“Consumerism means that patients will increasingly expect the ability to understand all their costs on their terms,” she notes. “Recently, Johns Hopkins put out a study that indicated that Ambulatory Surgery Centers that adopted price transparency as a solution saw an increased patient volume of 50% and then in some instances they saw an increase of revenue by 30%. So, we’re offering this solution to organizations that have a requirement but then also to those organizations they want to have a competitive edge in the market.”