Hospitals see challenges around price transparency, technology and resources

Jason Considine, Experian Health chief commercial officer, said regulations around price transparency and the No Surprises Act were among the topics discussed at the Healthcare Financial Management Association annual conference in Denver last week.

Both regulations are creating challenges, he said.

"With the No Surprises Act, there's a lot of work that has to be done to provide an accurate patient estimate," Considine said. 

Starting this past January, the No Surprises Act protects uninsured or self-pay individuals from unexpectedly high medical bills.

At a future date to be determined, providers also expect to be required to give a good faith estimate to insured individuals.

Getting these estimates involves having information about the patient's benefits and insurance plan to create an accurate estimate, Considine said.

Price transparency requires hospitals to provide clear, accessible pricing estimates online for at least 300 different shoppable services. Hospitals may face civil monetary penalties for noncompliance. 

Hospitals are concerned about significant challenges around deployment, especially the resources required,  according to a recent KLAS survey of 66 revenue cycle leaders. Hospitals are turning to third-party solution providers, among them Experian Health, Vitalware and nThrive, the KLAS report said.

On top of mind for most provider organizations is an expectation of spending to increase for technology as regulations expand, Considine said.

Experian recently took a look at what consumers want when it comes to price transparency and payment and found that 21% want a digital experience.

The survey confirmed what he and others already thought, according to Considine. 

Twenty-one percent said they interact with digital technology, but reported difficulty obtaining accurate cost estimates for appointments. 

Twenty-seven percent would use digital wallets to pay their healthcare providers if the option was available.

Currently, the most common way for patients to pay is when they are in the office, Considine said. But at least a quarter would prefer to pay online, which results in providers getting paid faster. Getting paid online also reduces the cost to collect.

"The more money we collect up front, the fewer statements we send," Considine said.  "And you get a better financial experience."

Some consumers prefer to pay bills after hours, and others may qualify for financial aid.

"Providers have to figure out the right financial pathway," he said. "It takes leveraging data to know the right financial experience."

Twitter: @SusanJMorse
Email the writer: SMorse@HIMSS.org
 

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