3 hospital revenue cycle leaders predict how price transparency will affect healthcare

Price transparency has come to the forefront recently amid CMS' new requirement that hospitals publish their standard charges on the internet.

To discuss this topic, healthcare revenue cycle management company PMMC hosted a roundtable interview with four experts from U.S. health systems.

Roundtable participants were Susan Downey, manager of pricing charge description master at Seattle-based Virginia Mason Medical Center; Jackie Woolnough, director of revenue integrity and professional coding at Cleveland-based MetroHealth System; Meagen Windler, director of revenue cycle at Indianapolis-based Eskenazi Health; and Kabby Thompson, director of managed care at Houston-based Texas Children's Hospital.

Here, three of the panelists share their thoughts on the biggest effect price transparency will have on healthcare in the next few years.

Susan Downey: Hopefully it will push the conversation. Financial health is as important for a patient as physical health. Currently, the tools for the patient to use to assist in decision making do not exist on a broad spectrum. Individual facilities can provide information, but only for the services they provide. It is up to the patient to track down all of the different information and they do not have a complete understanding of the system. While I do not believe publishing the chargemaster is helpful, it at least gets things started.

Meagen Windler: It is anticipated that this is just the beginning and more stringent guidelines will be placed on organizations to empower customers to make more informed decisions about where they want to receive their care. This will also force organizations to be more methodical in their pricing to ensure they are in line with the market and re-evaluate actual costs for the services provided in hopes of stabilizing pricing across various regions.

Jackie Woolnough: Two things: First, I hope that pricing transparency will eventually empower consumers to better understand how hospital billing and health insurance work. This way, they can make more informed decisions when choosing coverage options for them. 

Second, I feel that this will lead to a normalization of prices in regional markets. Hospitals will be forced to take a look at what they charge and what their price position in the market is. Hospitals that want to retain patients and avoid scrutiny will be forced to adjust their prices to the market. 

Read more questions and responses from panelists here.  


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