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What You Should Know About the Proposed Hospital Price Transparency

Posted By Giovanna Stahl
medical billing solutions

Price transparency is essential in aiding a well-functioning and competitive healthcare market. It tells patients what they owe for their care before they receive that medical bill week later, and empowers them to compare and shop for the most effective and lowest healthcare available. This gives consumers the power and promise of cost control as healthcare providers compete for the market share. However, the new proposed hospital price transparency has experts and health care providers a bit skeptical about how this new plan would be implemented into the market. Due to the shift in transparency, many opposers believe that this new plan would not only limit the choice of the patients but also increase the administrative burden on hospitals. 

 

We at ECLAT Health Solutions understand the stress on hospitals could be brought about by this order. As a distinguished healthcare support service, we are dedicated to working with hospitals and practices as a partner whose duty is to reduce the administrative burden that arises from this proposed plan, from our credible medical billing services to our reliable revenue cycle consulting, and much more. Below, we explain what is most important about the updated hospital price transparency: 

 

In the briefing statement of the proposed hospital price transparency, the President states that he wants to improve the price and quality of transparency in healthcare for American patients. This proposed plan will require hospitals to publicly disclose the reflection of what patients pay in an easy-to-read format. This order plans to make information more readily accessible for out-of-pocket spenders prior to care. By comparing different healthcare services, patients are able to identify their savings while still receiving the same services. Though the benefits of the proposed hospital price transparency are apparent, opposers are still skeptical about the true advantages of the plan and mainly focus on two key factors:

1. Patients Receiving Misinformation

Though the proposed plan will make the information more widely available, according to Recycle Intelligence, it would not give consumers enough information to make informed decisions about the products and services to purchase. Consumers also rarely use the price comparison tools that are currently available to use. Because of this, it limits the patients’ choices whenever they try to search for low-cost care and creates an anti-competitive market by harming the health system’s powers of negotiation. Conversely, patients rarely walk into a doctor’s appointment knowing exactly what they need. No one can pinpoint exactly which procedure a patient will require for a specific condition. Due to this, patients whose goal is to choose the “less expensive” procedure, may miss out on something they may need (i.e. having an MRI with or without contrast). 

2. Medical Care Is Not “Shoppable”  

Being “shoppable” means that the patients are able to look around and compare prices before they receive their treatment or procedure. According to Julie Appleby, a writer for NPR, only a portion of medical care is “shoppable”, such as prescription drugs, elective surgery, MRIs, and more. With this proposed plan, hospitals would be required to release the charges of each room fee or aspirin tablet and multiply that price by the number of insurers, making the total amount of data exponential and the dataset overwhelming for many consumers. Patients would need to know all of their information (tests, procedures, supplies, and more) and calculate the costs, prior to their visit. 

The Benefits of The Proposed Hospital Transparency

While there may be some opposition in regards to the proposed plan, the goal is worth noting. If self-insured employers and other health insurers have the transparency of an actual price, it will provide them with a stronger negotiation tactic in demanding better deals or steeper discounts from hospitals. Due to the administrative responsibilities that will increase because of this proposed plan, we are determined to assist in any way we are able. There is no price competition without knowing the price. 

ECLAT Health Solutions: Reputable Medical Billing Administrative Services

Price transparency is very important when considering your client's and patients' well-being. It aids in maintaining a competitive market. With the incoming proposed plan, the administrative duties of a hospital would begin to increase. At ECLAT Health Solutions, we seek to make that transition simpler by integrating our services such as dependable medical billing, clinical documentation improvement, and much more. To make this even more feasible, we focus on delivering the most flexible, accurate, and affordable coding and billing solutions available at a quality that exceeds our clients’ expectations. Fill out our form to schedule a free consultation to learn more about our services.  

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