How IU Health sets its systemwide price estimator tool apart

Indianapolis-based Indiana University Health had one primary goal when it launched a price estimator tool in 2015: greater cost transparency for patients.

Initially, the 16-hospital nonprofit system launched the tool on a small scale. Patients in the Indianapolis market could receive an out-of-pocket cost estimate for radiology procedures.

"We built a service in which we had a few people who could quote quickly … so we spent time building the platform out and then scaling up over time and getting used to how difficult it would be [to provide the cost estimate], how much time it would take us," said IU Health Senior Vice President and CFO Jennifer Alvey.

Three years later, the service is available at all of the system's facilities, including its physician offices, for any procedure or service. IU Health's financial navigators, scheduling and registration employees, and centralized estimates team work one-on-one with patients to provide them with cost estimates prior to their procedure or service. Ms. Alvey said their navigators can also help patients determine if they qualify for Medicaid coverage and help eligible people enroll. Patients can request price quotes via email, phone or the health system's online patient portal.

"It's about individualized care. We will reach out to the physician and make sure we're capturing everything, and there's a good handoff between front end and registration and scheduling," said Ms. Alvey. "It's all managed by the system patient access team, so coordination works well."

What makes the tool different?

While many health systems offer price estimator tools, IU Health believes their service stands out because of the scope of the estimate provided. The estimate includes all costs associated with the procedure/service, including the anesthesiologist, lab costs and radiology costs, rather than solely costs associated with the facility.

"A lot of systems have physicians separate from [the] facility side, or you may get multiple bills. What we try to do is put it all on one bill. Also, because we have all those services in the system, we can quote one price. We know what we are going to bill you as long as everything goes as expected from the clinical side," Ms. Alvey said.

IU Health also accesses tools that cover the patient benefit status for the overwhelming majority of payers in the market so the system can see how much a patient owes against their deductible or co-insurance. Therefore, Ms. Alvey said patients receive a quote not only for the total price of the procedure or service, but also for their out-of-pocket cost estimate.

"This is part of IU Health's strategy to respond to a growing consumer preference for more transparent healthcare pricing and personalized care," Ms. Alvey said. "It's very much about making sure each patient knows what they're getting when they come to IU Health. We try to design our services and our care for them, and then we want to be transparent about what that is going to cost them personally so they're not surprised at the end of the day when they receive their bill. So we view it as full, complete care, including their financial health as well."

Patients' response

Last year alone, IU Health provided 30,000 cost estimates to patients. The system is able to respond to more than 85 percent of estimate requests the same day and more than 95 percent within the second day of an estimate request. Ms. Alvey said some requests are more complex, so a couple days are needed to ensure the estimate is correct. Overall, though, patients have reacted positively. "A lot of the feedback is that it's all-inclusive. They like [that] we're putting the physician part in there too, and the radiology piece as well," she said.

Next step

Moving forward, IU Health aims to ask patients automatically at the time of scheduling whether they would like price quotes.

"We're not quite there yet, but that is our journey to even more transparency," said Ms. Alvey. "We do plan to get there."


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