Memorial Healthcare System aims to offer an online consumer experience comparable to the experience they have come to expect in other sectors of the economy.
Florida adopted a hospital price transparency law in April, but one Sunshine State health system is well ahead of the price and quality transparency curve.
Memorial Healthcare System in Hollywood, FL, which includes five acute-care hospitals, launched an online price transparency tool for self-pay patients in December 2014.
Annual views of self-pay rates increased 421% from 4,574 to 23,840, and annual views of quality information increased 193% from 2,757 to 8,082, for the one-year period ending June 1, according to Matthew Muhart, executive vice president and chief administrative officer for MHS.
The tool currently displays information for inpatient services including colonoscopies, cardiac procedures, imaging studies, and lab work.
Quality information was added to the online transparency tool in April 2015. By early next year, the health system plans to roll out an expanded version of the transparency tool that also will include price and quality information for insured patients, he says.
"It will appropriately identify the out-of-pocket requirements, the up-to-the-minute deductible position the person is in, and then marry that up with our contracting system so that we know that we can quote the exact amount of prospective payment at time of service," Muhart says.
Approximating the Amazon.com Experience
The ultimate goal is for MHS to offer an online consumer experience for patients that is comparable to the experience that consumers have come to expect in other sectors of the economy, he says.
"The full product will offer as close to an Amazon.com experience as one could have in healthcare, where the consumer could identify the service they want to receive from a Memorial Healthcare System facility, would be able to verify their insurance is taken by Memorial, would be able to understand exactly what their out-of-pocket requirements are, would be able to schedule a procedure, would be able to pay for their out-of-pocket requirements online, and also would be able to rate their experience with Memorial."
The online transparency initiative has not impacted the volume or pricing of MHS services, and the primary return on investment is expected to be elevating the health system's transparency image relative to competitors, Muhart says.
"So many factors come into play when analyzing patient volume by payer, so we have no definitive insight into whether this initiative is driving volume. We expect, over the long run, we will differentiate ourselves from others and ultimately earn more business."
Including information that helps patients gauge the quality of services such as Press Ganey's Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores is a critically important element of the transparency initiative underway at MHS, says Stanley Marks, MD, FACS, senior vice president and CMO at the health system.
"We thought it was critical that we put out cost, price, and quality [information] because what people really want is not just about the dollar, it's really about what they are buying," Marks says, "you want to know that you are getting a high-quality service for what you are paying your good money for."
The transparency initiative at MHS started with self-pay patients and a limited set of services because the challenges were manageable, Muhart says. "It started out with two criteria: high volume and predictability of the service to be provided."
Expanding to Other Services
Now, MHS is examining a broader set of hospital services to include in the online transparency tool.
"We have spent quite a bit of time conducting some complex statistical analyses of outpatient surgical procedures—looking at an array of providers who perform those surgical procedures and the types of patients who receive those procedures—to try to identify with a high degree of certainty the right price to quote before an outpatient procedure," Muhart says.
MHS is not ready to disclose the results of those analyses. But outpatient surgical procedure pricing and quality information will be available for self-pay patients soon, Stanley says.
"In the very near future, we will roll out fixed pricing for outpatient surgical procedures that will allow us to offer what the consumer wants, which is predictability and certainty about what a procedure will cost, and at the same time making sure that we price it appropriately."
"Anyone who is going to get involved in doing this sort of project needs a very tight team, with finance, the clinical side of the house, and patient- or family-centered councils," Stanley says.
"It you don't have alignment of those three components, you won't be producing information that is useful to the consumer, and that is what this is all about."
Christopher Cheney is the CMO editor at HealthLeaders.