3 revenue cycle leaders on their hospital's biggest concern now that standard charges are public

Healthcare revenue cycle management company PMMC recently hosted a roundtable interview with four experts from U.S. health systems on price transparency.

The discussion centered mostly on CMS' new requirement that hospitals publish their standard charges on the internet.

"CMS has been very clear and continues to reinforce the message that posting charges is the first step [toward price transparency]," said Greg Kay, senior vice president of revenue strategy at PMMC. "Their goal and their intent of these requirements is to make pricing transparency actionable."

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 hospital's biggest concern now that standard charges are public.

Jackie Woolnough: Our biggest concern is public misperception. We do not want patients to assume they cannot afford to have a necessary service performed based solely on the chargemaster price. We really want patients to understand that looking at charges alone will not give them the answer that they are looking for.

Meagen Windler: We echo others' concerns with the public misperception of what this information means to them. It can be a bit confusing for those who do not work in healthcare to interpret the information. As many of us are aware, we have to consider payer contracts, self-pay discounts, etc. while also understanding various billing models in addition to other tools provided for pricing, such as price estimation tools. All of these considerations in addition to the new CMS pricing transparency regulations will require us to provide more guidance and education to our customers.

Kabby Thompson: The biggest concern is misinterpretation of the chargemaster by patients, who might think that this is their out-of-pocket expense. 

Read more questions and responses from panelists here.  

 

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