The first step toward improving price transparency and the patient financial experience

Finance leaders often ask me where they should begin addressing consumerism. It can seem overwhelming, especially when you consider the consumerism gap between healthcare and other goods and services. I get that.

Here’s my recommendation: Before you swing into action, do an attitude check. Be honest with yourself. What’s your gut reaction to the prospect of developing meaningful price information for consumers? Maybe it seems like a lot of work for low return. It may seem easier to keep dealing case by case with unhappy customers. You may also be wary of what consumers will see when you pull back the veil on real pricing — without the disclaimer that few people actually pay chargemaster prices. Or you may be concerned about how disclosing payer-specific rates will affect your negotiating position with health plans. If so, you’re likely waiting to see if the CMS regulations mandating such disclosures will survive legal challenges.

These are all issues finance leaders have shared with me. Do they resonate with you? If so, give some serious thought to questioning your assumptions. And consider the implications of putting your head in the sand and simply avoiding the hard questions.

Some may object that relatively few consumers use price transparency tools. Have you ever used one? If you haven’t used your organization’s transparency tool, you should. You may find that the user experience and the results are not on par with tools for airline tickets or hotel stays or even used cars. Granted, making a healthcare purchasing decision is rarely as straightforward as buying an airline ticket or even a car. But falling back on that as an excuse just perpetuates consumer dissatisfaction. Until our industry makes it easier for consumers to get meaningful price estimates, we shouldn’t draw conclusions about their propensity to use transparency tools.

Also, when considering transparency strategies, don’t limit your definition of competitors to traditional providers. Disrupters are using consumer dissatisfaction with high prices and lack of price transparency as a competitive advantage. For example, if you Google “CVS visit price,” you’ll pull up a price list for all CVS Health services, with and without health insurance. Recall that when CVS Health acquired Aetna in 2018, it announced its intention to “transform the consumer healthcare experience” with 1,500 expanded health clinics slated to be open by December 2021. These HealthHUBs are designed, complete with a care concierge, for consumers who are managing chronic conditions. And CVS is just one of many disrupters changing the competitive landscape for legacy providers.

In the new healthcare marketplace, the old rules and ways of doing business don’t apply. Price transparency is not a cure-all for all that ails healthcare. But it’s table stakes for legacy stakeholders that expect to stay relevant and competitive in a changing world. Coming around to accepting that idea is where you should start on your consumerism journey.

Check out these consumerism-focused HFMA resources

• Explore HFMA’s new Consumerism Maturity Model, the topic of Joe’s next column, which will be featured at the Revenue Cycle Conference, Sept. 9-11, in New Orleans.
• View HFMA’s consumerism-related best practices.