What Does Price Transparency Look Like? – #HITsm Chat Topic

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 2/14 at Noon ET (9 AM PT). This week’s chat will be hosted by Edward Bukstel (@ebukstel) on the topic of “What Does Price Transparency Look Like?”.

For as long as I can remember, the topic of price transparency in healthcare has been identified as a solution to our national healthcare crisis.  Patients are going bankrupt from surprise medical bills and feel powerless to question the advice of clinicians and providers.

While patients are looking for more transparency in pricing and quality, hospitals, doctors and insurers are rallying to stop calls for making pricing transparent. Under proposed new rules, insurers would be required to make public the negotiated rates for in-network providers and out-of-network services as well as make real-time cost-sharing information easily available to members.  The CMS final rule on hospital prices was passed on November 15, 2019 and requires hospitals to post all negotiated rates with insurers beginning in 2021.

Furthermore, a separate hospital payment rule carries forward a previously announced plan to force hospitals to reveal negotiated rates.  This plan forced hospitals to publish their charge masters on websites, but the implementation has met with questionable results.   They will be required to share information about gross charges, payer-specific rates, minimum and maximum negotiated charges and the amount the hospital is willing to accept in cash from a patient.

Hospitals arguing against transparency, “Instead of helping patients know their out-of-pocket costs, this rule will introduce widespread confusion, accelerate anticompetitive behavior among health insurers, and stymie innovations in value-based care delivery.”

The payor community has also come out against any policy proposals that would increase price transparency.  The Blue Cross Blue Shield Association and the Alliance of Community Health Plans published the following in a statement:

“Unfortunately, the rules the administration released today will not help consumers better understand what health services will cost them and may not advance the broader goal of lowering health care costs,” BCBSA CEO Scott Serota said in a statement.

As patients, we demand access to our data, and as we are assuming more and more financial responsibility under high deductible health plans, we are also demanding more price transparency.  There are examples of excellent applications that support price transparency in pharmaceutical drugs, such as GoodRx.  We are also witnessing a rise in companies that help save patients money when they get a surprise medical bill on a retrospective basis.  The AARP recognizes the need to address balance billing and out of network charges.  Companies like Consumer Medical Billing Solutions also state that they save patients 25%-45% on medical bills.

Companies have tried to give us a look at which doctors and hospitals are considered “quality” through patient review and referral sites such as ZocDoc, HealthGrades, and Yelp.  Would you consider a doctor as being high quality if the average patient goes bankrupt in the process of receiving care?

Join us for this week’s #HITsm chat where we’ll discuss price transparency in healthcare.

Topics for this week’s #HITsm Chat:

T1: What online resources about pricing do you check prior to receiving medical care? #HITsm

T2: Do you believe price transparency will save patients money? If so, how much? #HITsm

T3: What are the top medical procedures or procedure classifications (MRI, Office Visit, Xray) that you’d like to see have more price transparency? #HITsm

T4: What is preventing us from having an application that presents price transparency for medical procedures? #HITsm

T5: What should patients do if they are unable to pay a medical bill? Should patients enter into a payment plan? Have you tried patient advocacy for medical bill negotiation? #HITsm

Bonus: How could healthcare price transparency be crowd sourced by patients? #HITsm

Upcoming #HITsm Chat Schedule
2/21 – Usability in Health IT
Hosted by Bennett Lauber (@uuAbility)

2/28 – Coronavirus and Digital First Thinking in Healthcare
Hosted by Mandi Bishop (@MandiBPro) from Gartner

3/6 – MIPS
Hosted by Joy Rios (@askjoyrios) and Robin Roberts (@RRobertseHealth) from Chirpy Bird (@chirpybirdhit)

3/13 – No Chat, but Enjoy #HIMSS20

3/20 – TBD
Hosted by TBD

3/27 – #UnblockHealth
Hosted by Grace Cordovano (@GraceCordovano)

4/3 – TBD
Hosted by TBD

4/10 – Emerging Strategies for Measuring and Managing Provider Burnout
Hosted by Jeffrey Becker (@BeckerJMB)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.