Patients are increasingly demanding upfront cost estimates as they take on more financial responsibility for their care.
By meeting this demand, hospitals and health systems have an opportunity to boost patient satisfaction. However, 43 percent of patients find it somewhat or very difficult to get this information, according to a survey from TransUnion Healthcare.
Toledo, Ohio-based ProMedica is looking to buck this trend and make it easier for patients to determine their out-of-pocket costs.
Jered Wilson, the health system's vice president of managed care and reimbursement, recently answered questions from Becker's Hospital Review about ProMedica's price transparency initiatives and how they are different from initiatives at other organizations.
Question: When did ProMedica's price transparency initiatives begin?
Jered Wilson: ProMedica has been working to make its pricing and price structure more transparent to our patients and the community since 2008. That year, ProMedica began posting our top 100 chargemaster prices on our website. Around the same time, ProMedica introduced an insurance hotline. The hotline was established to provide out-of-pocket estimates to patients.
In addition to the initiatives I previously mentioned, ProMedica now also makes available a web-based pricing request form and an online self-service tool. The web form became available in 2015 and the online self-service tool in 2016.
Q: What do these initiatives entail?
JW: The pricing hotline is available to all patients. ProMedica revenue cycle staff work with the patient and the patient's insurance company to provide a patient out-of-pocket estimate for any service billed by a ProMedica facility. ProMedica provides the estimate within 48-72 hours.
For patients who prefer to provide their request electronically, ProMedica also makes available the option to submit a request for any facility-billed service through an online form. ProMedica provides a response and an estimate within 48-72 hours.
Additionally, ProMedica recently worked with a vendor and three other health systems located outside of Michigan and Ohio to develop a real-time online estimator. The tool directly links to some of ProMedica's largest managed care payers to provide real-time patient out-of-pocket estimations for select services. Estimates are provided within a matter of seconds and have proved to be highly accurate. Due to the complexities involved, at this time the tool is focused on the more shopped or routine services, including laboratory, radiology and outpatient surgery. ProMedica is working with our vendor to expand the service portfolio but we are moving cautiously so as to not decrease accuracy of the estimates provided.
Q: What was the goal with these initiatives?
JW: ProMedica is a locally owned, nonprofit health system providing quality healthcare services to 27 counties in northwest Ohio and southeast Michigan. As a nonprofit, mission-based health system committed to community health needs, we believe many social determinants of health correlate to population health. Food insecurity, instability and deprivation are among them, contributing to health disparities in our 27-county region. Hunger among children, seniors, pregnant women and other groups has an impact on all aspects of wellness. Understanding the cost of healthcare services and helping patients make informed choices directly contributes to a more positive set of outcomes.
Our goal with price transparency is similar to our quality and experience goals. ProMedica seeks to serve the community as a trusted healthcare partner in care, service and pricing.
Q: What makes the initiatives unique from the other price transparency initiatives out there?
JW: ProMedica's focus on a multichannel approach is important for the purpose of engaging with our patients in the way that they would like to engage. Some patients prefer online tools, others prefer speaking to a live person. We offer both.
Q: Any future plans with these price transparency initiatives?
JW: In the near future, ProMedica plans to continue to further refine our online real-time price estimator. We've also established some internal work groups looking at further strengthening employee communication and education around ProMedica's value proposition.
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