Price transparency will be one of the top industry issues for 2014 according to recent Modern Healthcare and PwC’s Health Research Institute’s reports.
- Cost conscious employers are making price transparency a factor in negotiations with health plans and providers;
- A little-noticed provision in the Accountable Care Act (ACA) requires all hospital to publish and annually update their standard charges for items and services; and
- Patients, who are being asked to pay more out-of-pocket are demanding more information on healthcare prices.
A National Business Group on Health study found that more than 1 in 5 U.S. employers (22 percent) had plans that required a minimum deductible of $1,250. Also, because of the botched healthcare.gov rollout, the loss of medical insurance by over 6 million people, employers downsizing or moving employees onto the exchanges, many citizens will be required to pay more out-of-pocket for their healthcare. Moreover, according to the Wall Street Journal, “bare bones” plans that were supposed to become obsolete will survive because of a quirk in the ACA law — as long as companies offer at least one plan that complies with the law, they can keep offering ones that don’t!
There are a variety of tools that employers and consumers can use to research healthcare prices. State and federal websites, health plans’ claims data and private websites such as the Fair Health Consumer Cost Lookup offer some price information. Nevertheless, many patients will end up calling local hospitals and medical groups to check out the cost of their tests or procedures. And, no doubt, government and the media will test price transparency and publish the results.
In 2005, Devon Hill Associates conducted a study of price transparency at 64 hospitals sponsored by the California HealthCare Foundation — Price Check: The Mystery of Hospital Pricing. 622 calls and visits by mystery shoppers determined that there was a serious communications gap between hospitals and patients – a gap that management was often not aware of.
Several years later we conducted a mystery shopping study for 11 Virginia hospitals sponsored by the Virginia Hospital & Healthcare Association –– and found similar results.
How ready is your organization for real price transparency? Ask yourself: Do you know how price questions are actually responded to in your organization? Do patients encounter helpful, informative staff and/or user-friendly resources or tools? Mystery shopping is an opportunity for providers to obtain detailed feedback about their price transparency – and about the patient experience finding it.
Contact Barbara Gerber, President of Devon Hill Associates at (858) 456-7800 or complete the inquiry form on our website for more information about how to assess the state of your organization’s price transparency.
