Price Transparency

Zelis Acquires Healthcare Transparency Leader Sapphire Digital

What You Should Know: – Bain-backed digital health payments company, Zelis today announced the acquisition of Sapphire Digital, a healthcare consumer-centered pricing and navigation software company serving more than 100M members. Financial details of the acquisition were not disclosed. – Sapphire’s platform offers tools for provider search and selection, quality ratings and reviews, pricing data, …

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4 ways to strengthen digital patient access

In November 2020, Experian Health conducted a survey to capture consumer and provider attitudes regarding patient access. At the height of the pandemic, patients welcomed telehealth services and maintained their distance from hospital waiting rooms. Providers scrambled to implement and provide digital services that would help them maintain quality care for their patients. In June …

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How COVID-19 changed the patient journey: A call for digital transformation

COVID-19 changed every aspect of the patient journey – placing unprecedented demands on the healthcare system and accelerating the need for digital transformation industry-wide. Telehealth, touchless engagement, and self-service scheduling became the new normal; however, this created new stress on operations, administration, and finance. While this new normal comes with many challenges, data and digital …

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Insurer price transparency rule faces legal challenges: 4 takeaways

Two lawsuits, filed by the U.S. Chamber of Commerce and the Pharmaceutical Care Management Association, allege that portions of the price transparency rule governing insurers are unlawful and would drive up healthcare prices, contrary to the rule’s stated aim.

The State of Patient Access 2.0: 4 opportunities to strengthen the digital experience

“93% of providers say creating a better patient experience remains a top priority, up 3% from last year.” – Experian Health’s State of Patient Access, June 2021 Download now In November 2020, we surveyed patients and providers for their sentiments on how patient access changed because of the pandemic. During this time, patients welcomed the …

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CMS repeals MA rate disclosure requirement, boosts hospital payments by $2.3B

CMS has finalized its 2022 inpatient payment rule, which will not only repeal part of the price transparency requirements related to Medicare Advantage rates and increase payments to hospitals but will also require facilities to report Covid-19 vaccination uptake among its employees.

Only 5% hospitals are compliant with price transparency rule. Here’s how they did it.

The hospitals that were found to be fully compliant with the federal price transparency rule had a few strategies in common, including picking the right technology partner and beginning their efforts early — in some cases before the rule was even proposed.

CMS proposes fining hospitals up to $2M annually for not following price transparency rule

CMS’ latest proposed rule, which includes stringent penalties for hospitals that are found to be flouting the price transparency rule, comes on the heels of an analysis showing that a vast majority of hospitals are not in compliance with the regulation that went into effect on Jan. 1.

Biden’s latest executive order aims to boost healthcare competition

President Joe Biden has signed a new executive order to tackle anti-competitive behavior across American industries. With regard to healthcare, Biden is directing federal agencies to revise guidelines for hospital mergers, enable people to comparison shop health plans on the ACA marketplaces and work with states to import drugs from Canada.

Healthcare Transparency: Pandemic cool down turns up regulatory heat

The pandemic dominated healthcare in 2020, but it won’t be recognized as a reason to delay complying with CMS’ price transparency mandate, which went into effect on Jan. 1, 2021. In a recent study conducted by HealthAffairs indicated 65 of the 100 largest hospitals in America had not complied as of February 2021. And new …

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Beyond the pandemic: digital patient intake is here to stay

Will handshakes become a thing of the past? Will face masks become a regular feature of flu season? Will home-working remain popular, even after workplaces re-open? COVID-19 forced some abrupt behavior changes that challenged existing cultural norms, but as the pandemic subsides, how many of these adaptations will survive? For healthcare executives, the return to …

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CMS’ price transparency rule offers providers, payers a win, too

Patients are not the only ones who will benefit from the price transparency rule — providers and payers can also gain competitive advantages as a result of the regulation. These include being able to deepen relationships with patients and support payment contract negotiations.

CMS proposes putting $2.5B into hospitals’ coffers, eliminating part of price transparency rule

CMS has released its proposed inpatient payment rule for fiscal year 2022, which includes a payment bump that could increase reimbursement for hospitals by $2.5 billion. Further, in a win for hospitals, the proposal aims to repeal a part of the price transparency rule related to Medicare Advantage plans.

Smart Healthcare Platforms Shine a Light On Price Transparency

By MATTHEW DALE Did you know that as of January 2021, price transparency is being mandated for hospitals? But what exactly does that mean for company healthcare plans, third-party administrators, healthcare sharing organizations, employers, and employees?  It means U.S. hospitals are now required to provide clear, accessible pricing information online about the items and services …

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Boost Operational, Clinical and Financial Performance with Good Data

Peter Nelson, VP & General Manager, Global Alliances at GHX There’s an old adage that every challenge is merely an opportunity in disguise. COVID-19 highlighted the healthcare industry’s ongoing challenge with producing clean, standardized data. As the industry looks to rebound from the severe financial impact of the pandemic, there’s a renewed urgency among hospitals …

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Patients aren’t great price shoppers

That is the finding from a recent Health Affairs article by Desai et al. (2021). We launched a large online advertising campaign to increase consumers’ awareness about insurer-specific negotiated price information available on New Hampshire’s public price transparency website. Our campaign led to a more than 600 percent increase in visits to the website. However, in …

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Provider perspectives on the state of patient access

Providers know they need to improve their digital front door to withstand the financial impact of COVID-19, but change can feel risky, especially with so much uncertainty. Experian Health’s recent patient access survey offers a glimpse of what patients hope the digital front door will look like in 2021 and beyond. But what do providers …

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Waystar Launches Price Transparency Solutions to Meet Consumer Demand

What You Should Know:  – Waystar, a provider of healthcare payments software, today announced the addition of the Text Statements feature to its suite of payment tools. This new solution enables patients to easily view and pay medical bills directly from their smartphone, bringing transparency and convenience to the patient financial experience – a long-standing …

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Patient perspectives on the state of patient access

How has the pandemic affected consumer attitudes around patient access? What do consumers want when it comes to accessing care? These are the questions providers must answer if they are to survive the pandemic and lay the groundwork for future financial success. Experian Health’s recent patient access survey offers a glimpse of what patients hope …

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Humana, IBM Watson Health team up to provide access to AI chatbot

Through a new collaboration, Humana’s Employer Group members will gain access to IBM Watson Health’s AI-powered digital assistant. The chatbot will provide information on member benefits, claims, referrals and cost estimates for medical services.

A New System to Fit A New Economy: How Healthcare Can Recover From COVID-19

Paula Muto, MD, FACSFounder and CEO, UBERDOC, Inc. We are at a watershed moment. The COVID-19 pandemic has forced us to reevaluate our priorities both economically and with regard to public health. Living with a healthcare system that was created in response to an emergency measure during World War II, US consumers have struggled for …

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The future of patient access: digital front door

Experian Health products referenced in this blog post: Patient Engagement Solutions Patient Scheduling Precise ID Patient Payment Estimates Patient Payment Solutions To access more insights and trends, download the entire white paper:  The State of Patient Access: 2021 How has the pandemic affected consumer attitudes toward patient access? What kind of digital experience do consumers …

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30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021

As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021. Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and …

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Provider groups, hospitals file motion to stop CMS from enforcing price transparency rule

The American Hospital Association and several other entities, including some hospitals, filed an emergency motion to block CMS from enforcing the hospital price transparency rule set to take effect Jan. 1. Provider groups are arguing that complying with the rule would shift focus away from pandemic-related efforts.

2021 Patient Experience Predictions

As 2020 draws to a close and headlines hint that the end might finally be in sight for the pandemic, the healthcare industry is considering COVID-19’s legacy. The sudden shift to contactless care, financial consequences of widespread social distancing measures and changing expectations of the patient experience have upended the world of healthcare and health …

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How to improve collections and patient satisfaction with contactless payments

How did Starbucks lose $1.2 billion in sales during the pandemic, but still exceed revenue expectations in the last quarter? The answer lies in contactless mobile payments. By making it possible for coffee lovers to pre-order and pay for their morning cappuccino through a mobile app, the company was able to offer a safe and …

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Success at a glance: patient-centric collections

With high-deductible health plans, larger out of pocket costs, and confusion about medical costs in general, it’s no surprise that patients today face increased financial responsibility. Unfortunately, the current pandemic has introduced an entirely new level of financial responsibility and uncertainty for both patients and providers. Like many provider organizations across the country, Yale New …

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Patient acquisition and retention strategies to implement post COVID-19

A consumer-first healthcare revolution has been simmering for years. Despite efforts to create more human-friendly services, the industry still lags behind other consumer-centric sectors. Patients want healthcare to be simple, convenient and on-demand, but a persistent lack of coordination, accessibility and affordability leaves many struggling to navigate the healthcare landscape with ease. Is this about …

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Seniors navigating healthcare technology in a post-COVID world

Products referenced in this article: Social Determinants of Health Patient Schedule Member Match Coverage Discovery Patient Financial Advisor Patient Payment Solutions With just a few clicks, patients can book appointments, speak to their doctor, access billing information and pay for care, all without leaving their homes. Online health services have been a lifesaver for many …

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Is COVID-19 another catalyst for price transparency?

Few of us would buy a new car or TV without checking the price tag first. Why should our healthcare be any different? Yet this is exactly what many patients are forced to do when they need medical tests or treatment. Following the breadcrumbs on a provider’s website is a time-consuming and confusing way for …

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Three ways hospitals can support price transparency

The regulatory requirements for price transparency are in full effect. The Centers for Medicare and Medicaid Services (CMS) is moving forward with the OPPS Price Transparency Final Rule (CMS-1717-F2), which states that hospitals must provide transparency that will help consumers understand medical costs and make informed decisions. At this point, it is recommended that hospitals …

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Improving patient intake during COVID-19 starts with patient experience upgrades

Despite the majority of elective procedures being up and running again, patients are still keeping their distance. Nearly half of Americans say they or a family member have delayed care since the beginning of the pandemic, while visits to the emergency room and calls to 911 have dropped significantly. Patients are avoiding care, but it’s …

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Designing A Digital Experience to Drive Revenue and Patient Engagement

Bill Krause, VP and GM, Digital Experience and Consumer Engagement at Change Healthcare With the rise of healthcare consumerism, people are looking to hospitals, health systems, and physician practices to deliver the same user-friendly, digital experiences they receive from other industries. A recent survey found that more than 80% of consumers surveyed believe “shopping for …

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Success at a glance: price transparency

With so many complexities surrounding deductibles, premiums, copays and more, consumers sometimes struggle to understand the financial components of their health plans and are often unaware of the out of pocket for their healthcare needs. Recognizing that confusion about healthcare costs can make it difficult for consumers to ask the right questions, define priorities and …

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8 in 10 Consumers Stated COVID-19 Made Telehealth “Indispensable” in Healthcare Delivery

What You Should Know: – 8 in 10 consumers said COVID-19 made telehealth “an indispensable part of the healthcare system, according to a new study commissioned by Change Healthcare. – 2020 Change Healthcare – Harris Poll Consumer Experience Index reveals 65% said they plan to use telehealth more after the pandemic, and 78% said COVID-19 …

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4 Ways to Make Patient Collections More Compassionate

Medical expenses are often a source of anxiety for many patients, whether they are unsure about the amount owed or how they’ll ultimately pay for it. Unfortunately, intimidating collections processes don’t help, and a crisis like COVID-19 only exacerbates this stress. A more compassionate billing approach could help patients better navigate their financial obligations and …

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