price transparency
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Meaningful Hospital Price Transparency Requires Actual Prices, Not Estimates
Only actual hospital prices, displayed as dollars and cents, not estimates, formulas, or algorithms, protect patients from outrageous bills and hold hospitals accountable for overcharges, errors, and fraud. Accepting CMS’ or other substitutes instead of actual prices undermines broader efforts to make hospital price transparency a reality for American patients and healthcare consumers.
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Hospitals’ Price Transparency Compliance Is Improving Despite Remaining Low at 36%
About 36% of U.S. hospitals are in compliance with CMS’ price transparency rule, up from 24.5% in February, according to a new report. This progress will remain slow unless CMS can do a better job of effectively enforcing its rule, the report declared.
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Payer’s Place: Dawn Maroney
Dawn Maroney, President, Markets of Alignment Health and CEO of Alignment Health Plan, to discuss how they are using technology to provide better service and care to consumers.
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Ticking the Talons of Healthcare Transparency
As of January 1, employer-sponsored Group Health Plans and Health Insurance Issuers must make make the prices of 500 medical services available via an Internet-based tool. The Transparency in Coverage final rule gets even tougher on January 1, 2024, when the prices of all medical services must be made available via an Internet-based tool.
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Top 10 Hidden Facts About Hospital Prices
Here are the top 10 hidden facts about hospital prices that answer questions about why it is so expensive and why the bills are so complicated.
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3 Recent Healthcare Wins for Employers
Amid the difficult healthcare environment, it’s important to note that there have been some wins for employers, said Katy Spangler, senior advisor of the American Benefits Council, during the Midwest Business Group on Health conference held Tuesday. These wins include the No Surprises Act and price transparency rules.
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In Rare Move, CMS Fines 2 Hospitals for Price Transparency Violations
CMS recently fined two hospitals for alleged violations of its price transparency rule. These fines are only the third and fourth penalties issued by the agency since the rule took effect on January 1, 2021. These fines may become more common — CMS also announced that it is updating its enforcement process for the rule.
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Hospitals, MedCity Influencers, Opinion
Op-Ed: CMS Should Fine 30% of Hospitals It has Found to Be Violating Federal Price Transparency Law
As a first step to move toward greater hospital price transparency and lower costs, CMS can immediately issue $2 million fines on the 30% of American hospitals it concludes are noncompliant. If CMS takes enforcement seriously, the hospital industry will respond by quickly coming into compliance.
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The Promise of Healthcare Pricing Transparency: As Costs Rise, More Custom Solutions May Help Meet Demand
It’s not enough to be hopeful that hospitals with the right tools—and incentives will put prices out there on a menu for all to see. Luckily, for employers and employees who want to access affordable healthcare, new and emerging solutions are empowering them with information and options.
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Aneesh Chopra: VBC Will Bring ‘Radical’ Transparency to Healthcare for These 3 Reasons
Aneesh Chopra, president and co-founder of CareJourney, predicted accelerated enrollment in value-based care models in 2024 and 2025. He thinks this will greatly increase healthcare transparency for a few reasons, including making data more available and influencing more primary care doctors to act as health information fiduciaries on behalf of their patients.
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Applying Remote Patient Monitoring to Surgery Prep and Recovery, Oncology and Women’s Health
Join us to learn about the latest trends in remote monitoring and how to extend its benefits beyond chronic conditions to more patients – all while using fewer staff resources.
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MedCity Influencers, Consumer / Employer
Free Prescription Drugs Are Often Available—If Only Your Doctor Can Find Them
Price transparency has come a long way over the past couple of years, with insurance companies and hospitals now required to publicly disclose their prices. The more pressing issue is that there is no mechanism in place to make this information easily digestible, personalized to each patient, and placed in context with competitors’ prices.
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Making Pharmacy Benefits Transparent and Returning Control to Patients and Employers
Transcarent wants to transform the digital pharmacy benefit experience, enabling self-insured employers and their staff to make more informed choices.
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Price Transparency Compliance Is a Very Different Story for Hospitals Vs. Payers
Payers and providers face different challenges when it comes to compliance. The volume of price transparency data that hospitals must disclose online amounts to about 3 terabytes — compared to the whopping 630 terabytes of data that payers have been tasked with posting.
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Health Tech, Hospitals, Payers, SYN
Geisinger CEO: Price variability won’t be solved unless payers & providers get on the same page
Price transparency data has revealed there is a high degree of price variance for healthcare procedures depending on patients’ insurance carriers and the location in which services are delivered. Jaewon Ryu, Geisinger’s president and CEO, said that the only way this variability can be addressed is by getting decision makers on the payment side much more aligned with the care delivery side of things.
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Healthcare still has a few years to go before price transparency data makes an impact, Turquoise Health CEO says
The healthcare industry is still building software to can handle its complex and vast pricing data, so it still has a few more years to go before price transparency information actually becomes useful. Once software development cycle matures, this data can infiltrate the way providers and payers negotiate contracts and affect the way patients shop for care.
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INVEST DH Pitch Perfect winner spotlight: How TALON is creating the model for price transparency regulations
TALON was recently crowned winner of the Pitch Perfect contest at MedCity’s Invest Digital Health conference in Dallas. The company offers a suite of solutions to help stay compliant with the Transparency in Coverage Rule.
Promoted
Payer’s Place: Dr. Anil Singh
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
Promoted
Discover the Next-Gen Platform for Integrated Collaborative Care
Beyond EHRs and digital front doors, reducing the gaps in patient care journeys.
