In this special Speaker Series, Becker's Healthcare caught up with Katie Carow, principal at Carow Consulting.
Ms. Carow will moderate several panels during the Becker's Hospital Review 4th Annual Health IT + Revenue Cycle Conference on topics such as "Addressing High Deductible Patient Plans, Consumerism, and the Evolving Role of Patients Becoming Payers" and "Getting to the Bottom Line: Investing in Data Analytics to Reduce Operational Costs," both of which will be Friday, Sept. 21. Learn more about the event and register to attend in Chicago.
Question: What do you see as the most vulnerable part of a hospital's business?
Katie Carow: The low acuity and outpatient services are the most vulnerable to cannibalization in a hospital today. There are multiple options available to consumers that enable them to access care more conveniently, less expensively and with similar quality since consumers often evaluate quality based on amenities and services.
Q: What is the biggest barrier to price transparency in the healthcare industry?
KC: There are two major barriers to price transparency in the healthcare industry: the inability to accurately identify and assign costs to a procedure or length of stay and the dilemma that price transparency will negatively impact reimbursements negotiated with managed care and commercial payers.
When a singular service is being provided, assigning costs are relatively simple. However, when a complex procedure is performed that involves multiple resources — [such as] surgical implants, anesthesia, pre- and post-op recovery [and] rehabilitation, along with the care provided by numerous physicians and nurses — the complexity of establishing a price increases.
Price transparency also has the potential to impair a hospital's total net revenue. Additional business can be acquired from consumers who prefer to know their ultimate charges; however, in making these prices public, the opportunity to negotiate higher reimbursing contracts with insurance companies, which often offset lower government and self-pay contracts, is eliminated.
Q: What is the most exciting thing happening in health IT right now?
KC: One of the most exciting things happening in IT currently is the ability to access low-acuity primary care services directly from your mobile devices. The convenience of "care anywhere" from a [consumer] and cost perspective for both hospitals and patients is fabulous. When the primary care visit summary is integrated into the EMR, care continuity remains. At the same time, mobile care delivery dramatically reduces facility costs and allows healthcare systems to compete with the big boxes — Walmart, Walgreens [and] CVS — for primary care.