Hospitals must publish their standard pricing online, including the gross charge for each service, the payer-specific negotiated charge, discounted cash price, and the minimum and maximum negotiated charge. Inpatient and outpatient locations and pricing differentials must be identified, and all billing and accounting codes provided. All charge data must be included in a comprehensive, machine-readable file.
To help consumers more easily compare costs for common services, hospitals must also produce a consumer-friendly list of shoppable service bundles. The pricing for both the primary service and all related ancillary services should be included with each grouping.
of consumers avoid seeking healthcare because they don't know how much it will cost1
1 2020 Change Healthcare - Harris Poll Consumer Experience Index, 13 July 2020
At Change Healthcare, we see cost transparency mandates as an opportunity to improve the consumer experience and instill greater trust across the healthcare ecosystem. From our unique vantage point working with both payers and providers, we know that billing and payment experiences are among the primary drivers of patient dissatisfaction.
We believe that hospitals can address these governmental price transparency requirements in a way that differentiates their business from the competition. Up-front pricing transparency can foster an improved patient/provider relationship and reduce financial risk for both parties.
The new regulations are merely a first step on your digital transformation journey, as they provide the impetus necessary to embark upon necessary retail healthcare initiatives. By offering patients the quality data and personalized pricing information they need to compare providers and services, hospitals can secure patient loyalty, drive patient acquisition, and improve the care experience.
Providing patients with their specific costs for a given procedure—rather than simply a line item list price—is an empowering act that ultimately increases utilization.
Change Healthcare’s Clearance Estimator Patient Direct and Shop Book and Pay™ solutions provide consumers with an accurate estimate of their out-of-pocket expenses at or before the point of service. We help you comply with pricing transparency regulations while building a retail-style healthcare shopping experience to exceed your patients’ expectations.
of patients want to shop for healthcare entirely online2
of patients say their healthcare bills are more complex than a mortgage payment3
patients have gone to an appointment without knowing if they could afford it4
2 2020 Change Healthcare - Harris Poll Consumer Experience Index, 13 July 2020
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