For example, Oklahoma-based INTEGRIS health system developed a price estimate tool that provides about 240,000 prices for outpatient procedures each year. The Priceline tool gathers pricing information on outpatient services and links the data to information on financial planners for consumers to use before, during, or after their encounter.
The health system reported that the price quotes from the tool are accurate, being between three and five percent of the financial charge.
INTEGRIS not only saw healthcare price transparency increase after Priceline implementation, but also their hospital costs decrease. Putting transparent, accurate pricing information into the hands of patients and providers helped the health system direct patients to lower-cost clinicians within the health system’s network.
Accurate pricing estimates prior to care delivery also increased point-of-service patient collections from $1 million in 2008 to $18 million by 2015.
Software and other health IT systems that rely on historical claims data can also help hospitals and health systems boost price transparency, explained Sean Lundy, CMPE, of the Hand & Wrist Center of Houston.
“It is critical for providers to use accurate estimates when collecting the patient responsibility, as inaccuracies can generate added follow-up expenses, such as refunds and bills, which may turn profitable procedures into losses,” he wrote.
“Since obtaining current allowable amounts directly from payers can be challenging, to say the least, providers should use software tools that assess historical data and estimate allowable expenses for specific payers and procedures.”