PART 1 – January 2022 Price Transparency Series: Advocacy Groups & the Press

As we begin the second year of expanded Price Transparency, the healthcare industry faces a multi-pronged public relations assault. CMS and the press are now identifying hospitals that have failed to meet CMS regulatory mandates. This special series of ChargeAssist® Update News focuses on root causes of the growing negative image of our industry relative to prices. This is part one of our three-part series on Price Transparency’s impact on hospital reputations and public relations.

Negative Press about Hospital Prices

Journalists have focused on unreasonable hospital prices for over a decade. Stories abound of patients’ financial strain when strapped with significant out-of-pocket obligations. Venerated news agencies have picked up on this topic from 60 Minutes to Time Magazine to PBS. Today, nearly every top newspaper or healthcare news website has visited this hot social topic.

When Price Transparency was in its early years, investigative stories focused on prices for commonly used items and services from lab tests to MRIs. Since hospital pricing, Hospital Information Systems, and patient care are complex and highly varied, arguments about pricing were difficult to dispute without comparative data.

Rather than address the root cause of excessive pricing, regulatory mandates focus on disclosure and rely on market forces to create change. However, the pace is slow. As patients accept higher deductibles and coinsurance responsibilities, out-of-pocket hospital costs impact millions more Americans every year. Negative press will surely continue as many of our nation’s hospitals have failed to address the topics of charge data integrity and defensible pricing.

The focus of the press isn’t expected to ease. After 2021’s expanded Hospital Price Transparency regulations became effective, a renewed focus in local and national news resurfaced. As more research is performed with easily-accessed Charge Master files, we anticipate that hospital pricing will be highlighted by the press in 2022 and beyond. For a look back, here are two articles worth revisiting from the author who achieved wide-spread press on his criticism of hospital pricing:

https://time.com/198/bitter-pill-why-medical-bills-are-killing-us/

https://www.npr.org/sections/health-shots/2015/01/05/375024427/americas-bitter-pill-makes-case-for-why-health-care-law-wont-work

The government’s multi-pronged enforcement approach, including monitoring, warnings, fines, website postings, and public engagement methods clearly influence the press. As we enter the second year of expanded Price Transparency, we should expect continued attention from news media.

Criticism of the Hospital Industry’s Pace

Reasons for hospitals’ slow adoption of Price Transparency have included: waiting for AHA legal action, concerns about negative competitive effects, payer contract confidentiality, lack of staff for developing Price Transparency solutions, and inability to engage timely external solutions. None of these are viable arguments in 2022 and beyond.

The press has voiced growing criticism on the topic of Price Transparency. Today’s unofficial and often unsolicited surveys from third parties continue to show poor industry results. For example:

  • In July 2021, a group called “Patient Rights Advocate” published a critical paper on the industry’s lack of compliance with Price Transparency regulations. The weblink to the full report follows:  Patient Rights Advocate Semiannual Hospital Price Transparency Compliance Report July 2021
  • According to The Wall Street Journal, by September 2021, CMS had already issued 256 hospital warnings, and by October, it was reported that 32 hospitals were issued demands for corrective action plans. As of December, these counts increased to 335 warnings and 98 corrective action plan demands.
  • A software vendor survey published in October 2021 reported only a 17.2% rate of compliance for hospital postings of cash and negotiated shoppable services rates.

Reports showing non-compliance to Price Transparency mandates may cause significant public relations damage (even if you’re on your way to meeting rules in 2022). When reviewing articles, consider the date, the timeframe of any referenced surveys, and the neutrality of the author.

However, if your hospital is called out, few responses will be satisfactory in the public eye. Such news will surely cause a stir in your community, among hospital staff, and at the highest levels of Boards and Executive teams. Based on past history, our team believes that negative press on Hospital Pricing will ebb and flow as newsworthy information surfaces.

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