Healthcare News & Insights

Pricing transparency: What’s next for hospitals

A new year means new requirements for hospitals: As of Jan. 1, facilities must now post the prices of their treatments on their websites, per regulations from the Trump administration designed to improve pricing transparency. And there may be more changes down the line to shed light on healthcare pricing. 

The Centers for Medicare & Medicaid Services (CMS) updated the terms of its Inpatient Prospective Payment System (IPPS) for 2019 to state that hospitals must publicly post a list of their standard charges online in a machine-readable format. The info must be updated annually or as necessary.

According to an article in Kaiser Health News (KHN), the rule’s presenting some challenges already. Most facilities have opted to simply upload (or cut and paste) their chargemaster lists to satisfy the requirement to include pricing info online.

While pricing info’s been posted on many hospital websites across the country, it’s not always easy for patients to find. Per the KHN article, users may need to search online for terms such as “chargemaster” to get the list to show up for their local hospital.

Plus, chargemaster data may be confusing to patients, so your billing department may be fielding calls and questions from people who can’t understand the shorthand or the medical codes used.

Future of pricing transparency

It may be easier for facilities to post the chargemaster list as-is in the short-term to fulfill the new requirements, but it’s likely they’ll have to come up with a more user-friendly solution in the long run.

Here’s why: CMS is currently evaluating ways to make pricing even more transparent to patients. Given that so many factors may impact a patient’s final hospital bill (including whether they’re treated by out-of-network providers), it can be challenging to understand what’s owed and why.

When CMS initially released the final IPPS rule, it asked for comments from the public on how the agency could provide patients with better healthcare pricing transparency, including ways to remove barriers that keep clinicians from giving patients an honest picture of their treatment costs.

Using these comments, the agency’s considering future rulemaking on pricing transparency that defines providers’ role in the process and puts guidelines in place to help hospitals better inform patients of their financial obligations.

How to respond

Hospitals that want to get ahead of the game may want to consider how they can present their current pricing data in a way that patients can easily understand, instead of simply uploading the chargemaster to their websites.

It’s also a good idea to start evaluating your current billing and collections process to see if there are any ways your staff can provide patients with a more accurate look at their financial responsibility up front. You may also want to look at providing flexible billing options such as payment plans to make it easier for patients to settle their balances.

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