A bit more price transparency is coming to hospitals. Will it matter? #USNHoT
In a matter of weeks, hospitals across the country will be required to post standard charges online to comply with a price transparency final rule CMS published in August, and hospitals and doctors alike are on edge.
Some 43% of healthcare providers aren't sure how they'll address the mandate, and 92% are concerned about how their charges will be perceived by the public, according to a recent survey from revenue cycle software company PMMC.
The CMS rule requires hospitals to "make public a list of their standard charges via the Internet in a machine readable format, and to update this information at least annually." The agency had already required hospitals to make their standard charges public, so the change is more a nudge.
Still, the mandate has industry insiders talking.
"Everyone thinks transparency is a great idea for everyone but themselves," Thomas Lee, chief medical officer at Press Ganey, said during a panel on transparency at last week's U.S. News Healthcare of Tomorrow conference in Washington, D.C. "That tells you transparency is probably good for all of us."
At the same panel, hospital execs warned that physicians are the ones who will need to be ready to face consumer backlash.
Tom Miller, chief medical officer at University of Utah Health, said the mandate starts a national conversation on why costs are "so dang high" and what can be done about it.
"When the public sees this, they'll be asking, 'Why do I have to pay more than Blue Cross Blue Shield? Why do I have to pay more than Medicaid,'" Miller said. "'Why am I picked on as an individual seeking access to the healthcare I need?'"
Lee disagreed. Economists, he said, generally say price transparency doesn't have an impact on efficiency and cost.
"I'm predicting not much will happen and people won't pay attention to it because the charges aren't actually relevant to the vast majority of people," Lee said. "If people are uninsured, I doubt they're looking at these things either."
A survey of 1,300 adults conducted by the National Opinion Research Center at the University of Chicago earlier this year found more Americans fear their medical bills than serious illnesses.
With the Jan. 1 start date for the hospital pricing transparency rule closing in, Miller said physicians will need to start taking cost into account when providing treatment.
"Physicians are under-trained in the area of cost and need to pick up the flag," Miller said. "You should be able to know what things cost. You should be aware of that and be advising your patients and their families on what the cost of care will be."
Margaret McKenzie, president of Cleveland Clinic's South Pointe Hospital, agreed.
"We're going to have to teach caregivers how to provide care at the lowest cost. You have to disincentivize people to order random tests," McKenzie said. "I think we've got to start retraining students from medical school residency because that's the future. If we continue the way we're going, it will get out of control. We've got to mitigate those costs."
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