The healthcare industry is still getting a grip on how to comply with federal price transparency rules that would help patients make sense of its vast and complex pricing data, so it still has a few more years to go before this information actually becomes useful for patients.
That’s according to Chris Severn, CEO and co-founder of Turquoise Health. Severn’s company is a healthcare pricing platform that tracks the state of price transparency compliance among providers and payers each quarter. On Tuesday, Turquoise published a report outlining how the healthcare industry has progressed on price transparency compliance so far.
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The report found that 76% of hospitals have posted a machine-readable file, 65% have posted one with negotiated rates, and 63% have posted one with cash rates.
The providers that still haven’t published price transparency data are mostly independent hospitals, Severn said. He attributed this to two reasons, the first being that independent hospitals often lack the resources and technology expertise needed to meet the Centers for Medicare and Medicaid Services’ requirements. The second is that CMS levies smaller fines on independent hospitals, so some of these hospitals might feel like the small financial hit is worth it if it allows them to focus on more pressing priorities.
A full 55% of short-term acute hospitals (2,264) achieved a 5-star rating on Turquoise’s price transparency scorecard. This means that these hospitals published a machine-readable file that contains the cash, list and negotiated rates for “a significant quantity of items and services,” according to the report.
Several major health systems had five or more of their hospitals earn 4.5 stars or more on Turquoise’s scorecard. Some of these include Mayo Clinic, HCA Healthcare, Kaiser Permanente, Bon Secours Mercy Health, Geisinger and Intermountain Healthcare.
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Though these numbers are certainly moving in the right direction, healthcare is still in the “early to middle portion of what the industry calls the software development lifecycle,” Severn said.
“All of the tools that will embed and ingest price transparency data are all in mid-development and early releases,” he declared. “We’re still seeing the sheer size of this price transparency data make its way to a usable format that can then be embedded into new software.”
Once this software development cycle matures, price transparency data will be able to truly percolate and find its way to the rest of the industry, Severn said. Over the next year or two, he expects we’ll start to see this data being disseminated to patients.
Price transparency information cannot meaningfully affect the way rates are negotiated nor empower greater consumer awareness until this data becomes more prevalent across the industry, Severn pointed out.
“This data can eventually infiltrate the way providers and payers negotiate contracts, as well as get in front of patients in the EHR or their care navigation app,” he said. “We still haven’t achieved the ubiquity of this price transparency data or the adoption of new price transparency technologies. That separates the next phase, where we really start to see true behavior change — change in the standards that providers and payers use to negotiate contracts, changes in the expectations of consumers of healthcare.”
Source: erdikocak, Getty Images
