HFMA: Healthcare Pricing Transparency a Shared Responsibility

Christopher Cheney, for HealthLeaders Media , April 30, 2014

A report setting principles and recommendations for achieving greater price transparency in US healthcare suggests the task will require cooperation between healthcare providers, payers, and employers.

Price transparency is a critical element to reforming the US healthcare system, says a report released this month by the Healthcare Financial Management Association.

"Patients are being asked to take on an increasingly significant share of the payment for healthcare services. They are looking for higher value providers: those that offer quality services at a fair price," Richard Gundling, VP of healthcare financial practices at HFMA, said in an email exchange. "It is impossible for them to make decisions about the value of a provider without having price as a component."

Why Is Healthcare Price Transparency So Hard?

The authors of the report wanted any form of price transparency to be easy to use and easy to communicate to stakeholders. They set the following goals as the foundation for price transparency reforms:

  • Should empower patients and other care purchasers to make meaningful price comparisons prior to receiving care.
  • Should be paired with other information that defines the value of services for the care purchaser.
  • Should ultimately provide patients with the information they need to understand the total price of their care and what is included in that price.
  • Will require the commitment and active participation of all stakeholders.

"Transparency won't be successful without clarity of information, or without easy accessibility. The basic point is to make it easy for patients and other care purchasers to make decisions about which provider offers them their desired level of value," Gundling said.

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4 comments on "HFMA: Healthcare Pricing Transparency a Shared Responsibility"

Jack Durbin (4/30/2014 at 1:57 PM)
I would add to the information shared about pricing transparency the tension between services delivered at a hospital compared to a clinic or outpatient center. There are significant added costs to provide a 24/7 full service facility compared to a M/F day time service. Even for patients with insurance, increasing deductible costs are making patients select the point of care with the lowest cost as that is the usual basis for their out-of-pocket expense. What they don't realize is that in smaller communities, these choices may make the difference in the scope of services that the local hospital may continue to be able to offer.

Fritz Stephens-Tiley (4/30/2014 at 12:21 PM)
As usual this article has missed the boat. The notion of "price" transparency is irrelevant when you have providers setting their "prices" at, in most cases, over 200% of their costs. Cost data is freely available via CMS cost reports that hospitals are required to submit annually. The health care industry is a cash cow for those willing to exploit it. Insurance companies are no better when they consistently do a poor job of negotiating with providers for more realistic reimbursement rates. They simply pass any rate increases to their members in annual premium hikes. The "Free Market" has failed us.

Cody (4/30/2014 at 10:12 AM)
While pricing transparnecy is the responsiblity of the provider, once pricing is provided it's the responsibility of the patient to pay for their care. A lot of what is being missed in what is being described in most articles related to hospital pricing is the fact that a majority of patients don't meet their payment obligations. Thus the ever increasing amount of hospital bad debt and uncompensated care. In addition, not often mentioned is the self pay discounts, charity and other forms of discounts provided to patients. As with most people that have bought a car, you rarely pay the "sticker price".




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