As hospitals across the country put in months and months of effort to meet the Hospital Pricing Transparency Rule that went into effect on January 1st, 2021, many set their sights on one fundamental success measure: compliance. The massive amount of work required to simply meet the minimum requirements of the rule meant that nice-to-have extras might have to wait. With the deadline now (thankfully!) behind us, organizations have an opportunity to leverage that momentum, refocus, and optimize their pricing transparency tools with patient satisfaction at the forefront.
When thinking about potential improvements related pricing transparency, groups should consider the following questions:
1) Are we doing our best to ensure patients understand how to use the tools available to them and can interpret and understand the output they are seeing?
2) How confident are we in the ongoing accuracy and completeness of the cost estimates presented to patients?
3) What will our governance process be for these price transparency offerings so that information provided to our patients remains relevant and useful?
Patient Education and Communication
Understanding a bill or estimate can be challenging even for the savviest of patients, but where should an organization begin to better explain and communicate? Find clues to what’s challenging by tapping into the questions or concerns that your customer service or financial counseling teams receive.
If patients are confused by what they are seeing, these individuals will be the most likely to hear about it. Start off by ensuring your organization has a mechanism to compile these questions and challenges that is trackable and reportable. Then, distill that information down to identify trends and opportunities for improvement.
Using that information, and tapping into patient engagement and marketing resources, the sky is the limit when it comes to creating engaging and informative patient-facing content. Animations, videos, FAQs and more can be employed to help patients navigate and truly make the most out of the tools you worked so hard to implement.
Estimate Accuracy Enhancement
Although every organization will have undergone an extensive QA process before publishing their patient-facing cost estimate tools, those focused on providing high-quality information to patients should continue those efforts even after going live, albeit in a modified fashion.
Because “guest shoppers” may never become actual patients, you may simply never hear feedback from these individuals if an estimate was confusing, incorrect, or in need of an update. In order to keep an eye on the cost estimate quality over time, consider a “secret shopper” approach. Financial counselors who create estimates every day can occasionally log on to your cost estimate tool intended for guests and recreate an estimate there. Doing so allows that individual to validate that an estimate displayed to a guest shopper aligns with an estimate created internally and could bring to light potential issues.
Ongoing Governance Process
Maintaining accurate and relevant pricing transparency tools in the long run requires clear ownership expectations. Which team and individuals ultimately have responsibility for their oversight? Consider establishing a governance committee that will meet biweekly or at least monthly to review issues and assess opportunities for enhancement and expansion.
To make the best use of the group’s time, identify an analytic resource who will be tasked with compiling information and queueing up content for the committee to consider. Epic provides an excellent dashboard that displays estimate accuracy metrics in several different ways, but it can be a lot to digest. With some time dedicated to preparing both the qualitative and quantitative data available within your organization in advance, a pricing transparency governance committee can affect meaningful changes with an eye toward the ongoing trend of improving and expanding patient-facing, self-service tools.
Looking to take your pricing transparency approach to the next level? A comprehensive, patient-focused strategy can move the needle from merely compliant to giving your organization a competitive advantage. The Wilshire Group can create a roadmap to get you there. Please contact us to learn more about what’s possible.
