Penn State Health's Dan Angel: 2 tips for making prices transparent

Efforts to make healthcare prices more transparent are gaining steam at the federal level.

Since Jan. 1, CMS has required hospitals to publish their standard charges online in a machine-readable format and to update the information at least once a year. 

CMS also included price transparency requirements in the 2020 Medicare Outpatient Prospective Payment System proposed rule. The rule, released July 29, requires hospitals to publish the rates they negotiate with payers for hundreds of services consumers are likely to shop for in a searchable and consumer-friendly manner.

Some hospitals and health systems already have price transparency in place. Hershey, Pa.-based Penn State Health announced the Aug. 6  launch of a pricing tool on its hospitals' websites.

Becker's Hospital Review recently caught up with Dan Angel, Penn State Health's vice president of revenue cycle, to discuss the pricing tool, his organization's other price transparency efforts and the advice he would pass along to other hospital revenue cycle leaders.

Before taking on his current role, Mr. Angel was vice president of revenue cycle at the Penn State Health Milton S. Hershey Medical Center. He's also held roles with Danville, Pa.-based Geisinger Health System and Wichita, Kan.-based Via Christi Health., now Ascension Via Christi.

Editor's note: Responses were lightly edited for length and clarity.

Question: What is the biggest price transparency challenge revenue cycle leaders face?

Dan Angel: One of the biggest challenges for revenue cycle leaders — and I believe that consumers face — is a lot of the confusion around transparency and understanding the cost of services that you're going to incur at a healthcare facility. Back in January, CMS put out the rule to have hospitals publish their chargemasters on their website. But that does not tell the full picture and probably causes more confusion, because it's a list of our standard gross charges and doesn’t really give the patient insight into what their actual out-of-pocket cost will be.

Q: What efforts has Penn State Health made to address this challenge?

DA: In the last few years we have [supported] several functions to improve price transparency for our patients. The most recent is the online price transparency tool that allows the consumer to enter their insurance information and receive a real-time estimate of their out-of-pocket responsibility, taking into account insurance benefits and contracts Penn State has with its various third-party and government payers. We've also created a financial navigation team, a subset of our financial counseling team, which help[s] uninsured and underinsured patients identify third-party options and charity care assistance. This financial navigation team works proactively and reactively to inform patients about their out-of-pocket cost, [help them understand] any prior authorization requirements for services that are scheduled, and help them answer any questions in regard to the financial aspect of their continuum of care.

Q: What makes Penn State Health's price transparency efforts unique?

DA: I know many organizations have jumped into the price transparency realm because consumerism is definitely advancing in healthcare. Folks want to know what they're going to pay for a procedure. One of the things we are doing that is unique is we are taking a more proactive approach to informing our consumers about the financial continuum of care, and I'm not sure that has taken full effect in the industry. We will proactively reach out to our patients for scheduled procedures to help them navigate the total cost of their care. And if they can't afford to pay for their service, whether they're uninsured or underinsured, we will work with them to find different options, including financial assistance. We want full transparency with our patients as far as understanding and navigating their care so they can focus on the medical part and not the financial.

Q: What are the next steps with the system's price transparency efforts?

DA: We certainly want to expand our financial navigation program. Today, both with the online tool and our proactive financial navigation approach, we will communicate with patients for selected procedures. We'd like to expand that to more procedures based on demand and internal resources. We [also] have a patient portal, which our patients can access to understand the financial and clinical aspect of their care. We think we can do more with our portal as it pertains to transparency. We're continuing to evolve and try to stay ahead of the curve.

Q: What is your advice for other hospital revenue cycle leaders seeking to improve price transparency?

DA: Listen to your consumers. I personally interact with many patients and prospective patients and like to take their feedback. Like any business, the leaders of that business should listen to their consumers to understand what their expectations are and would make them comfortable in choosing your facility.

Another [tip] is constantly seek feedback from your peers in the revenue cycle industry. There are a lot of organizations out there where you can network with your peers and understand what they're doing so you can align with best practices as necessary.

 

More articles on healthcare finance:

AMA urges CMS to streamline Medicare audits
Hospital chargemaster management: 4 tips for improvement
Charity care took 5-year dive at California hospitals

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