Building Your Practice’s Approach To Price Transparency

Thriving In the New World of "Patient as Consumer"

February 12, 2019

When hospitals recently were required to post all standard charges online, industry observers positioned the move as the latest example in a continued shift toward consumerism in healthcare. Accelerating the shift: growth in walk-in clinics and telehealth options that feature published prices; a proposed HHS rule that would require drug-makers to disclose list prices in some ads; and an AMA policy suggestion that all health professionals be required to make price information readily available.

With health care taking significantly more from patients’ pockets each year (and in many cases, threatening their financial security), patients have begun making the same value comparisons they require for other major “purchases” in their lives. And so, they’re demanding more price transparency from an industry accustomed for decades to selling its services based on trust and waiting for a third party to determine the price and unveil it to the buyer later when the claim settles.

Physician practices are, of course, caught in the middle and on the front lines. You’re the ones most often communicating with patients about expected costs and setting expectations. You’re also the ones dealing with patient frustration at your front desks when they learn those costs, or later, when they’ve seen their EOBs. On the front end, you’re expected to price something that hasn’t happened yet and may change depending on clinical decisions; estimate patients’ out-of-pocket costs based on their particular insurance plan (correctly divining where they stand in their deductible at that given point); discuss sensitively their ability to pay; and deal diplomatically with their responses – all while not bringing your daily operations to a grinding halt. Electronic Health Records have further complicated the issue since charges are not ready until the physician signs the note which may be after the patient leaves the office, versus the old superbill environment where charges were available at check out.

Practices that thrive must not only respond to the larger industry shift that’s occurring, but also proactively take control of their own future path. At a minimum, every practice should be able to 1) develop a means – given the strengths and limitations of its own operations – to reasonably estimate what a patient will owe after an encounter; and 2) communicate genuine concern for patients’ growing stress around this issue.

Physician Interlink can help practices navigate this new environment, working with you to develop a price transparency policy that is realistic and achievable. We’ll work with you to optimize a transparency strategy that takes into account your particular specialty, patient volume and average patient balance. We’ll also assess technology resources that can help in this process. And finally, we’ll train your staff so that they understand your strategy, can manage your process going forward, and can communicate with patients effectively.

Practices that are able to succeed with transparency will have a marketing advantage with patients. You’re doing your part so that patients can be more informed advocates in their own care. Right now, even under new regulatory guidelines on transparency, patients are being given big blocks of data rather than information they can use meaningfully to make decisions. Practices that help patients bridge that gap are going to be at a major advantage as patient consumerism picks up speed.

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