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Calling all finance leaders: Price transparency needed now

Posted Jun 27 2013 10:01am

by Ilene MacDonald, FierceHealthcare

Last week I had the privilege to attend the Healthcare Financial Management Association in Orlando, Fla., when it announced its release of draft best practices for financial interactions and the establishment of a task force to address transparency issues .

These bold moves, under the direction of HFMA President and CEO Joseph H. Fifer, come at a time when the healthcare industry is under siege from all directions--the government, payers and consumers who are fed up with rising costs and don't understand their out-of-pocket expenses.

Healthcare financial leaders can no longer keep their head in the sand and ignore the role that healthcare spending has played in breaking state and federal budgets, Fifer said. It's time for them to step up and lead the debate about healthcare costs within their communities. "People want to know why healthcare costs what it does and what we're doing about it," Fifer said. "We need to move beyond the rhetoric."

The concept--to create a pricing structure and rationale so that patients understand upfront how much they will need to pay for out-of-pocket expenses--is so simple and necessary but one that requires buy-in from all stakeholders.

And for those who say that prices don't mean anything, Fifer countered that response will no longer fly in an environment where more and more employers are turning to value-based plans and accountable care organizations care for 10 percent of Americans.

"Have you tried to navigate your way through the financial maze of healthcare?" Fifer asked. "Have you asked your patients, or customers, what it's like?"

This common-sense approach to tackling the center of the healthcare debate: finances. "The reason the debate is so raucous is because of money. Should not the people who deal with money have a voice," Fifer asked.

I hope the financial leaders across the country will take Fifer up on his challenge and start finding ways to improve financial interactions and making pricing more understandable to the average consumer. HFMA is taking the first steps by developing best practices that will provide consistency, clarity and transparency in patient financial interactions.

But finance leaders can also turn to organizations that have taken the lead in this initiative. For example, Beth Israel Deaconess Medical Center presented a session at HFMA describing the project they launched this year to reduce patient dissatisfaction by eliminating the "sticker shock" reaction that so often occurs when patients receive the hospital bill for services in the mail.

In May the hospital piloted a program in the obstetrics department to provide accurate estimates of the cost of services prior to the patient receiving services. The estimates, offered in English and Spanish, include a detailed explanation of the service, how much the payer is expected to cover and the patient's financial obligation. The program will soon roll out to Beth Israel's radiology department followed by orthopedics, surgery and clinics.

While Beth Israel patients may still not like the amount that they have to fork over, knowing how much they will owe ahead of the time does take the sting out of it. And that's what Fifer hopes for other institutions.

"Great steps have been taken," Fifer told the financial leaders in the audience. "However, we're not done. Everyone in this room has contributed to how we got to this point. Now, everyone has a role to play in the solution."

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