Price Transparency 2021 – Are You Ready?!?

Ryan Sommers, PMP - Senior Director, Epic Practice
Aug 07, 2020

Price Transparency is coming. January 1, 2021 to be exact.

Unless it changes.

Either way, are we ready?

Are YOU ready?

Most agree, and studies have in fact shown, that price transparency is an important consumer factor, and can directly impact choices made, along with the overall amount spent on routine medical services.

Exactly what it should look like however, has caused much debate. Hospitals are concerned that patients will be more confused than ever, when what they truly want and need are out of pocket costs. Displaying the actual contracted rate for services may actually dissuade patients from getting care at times. There’s also concern over the possibility that payers will have added leverage and won’t be willing to negotiate lower once disclosed.

No matter how these concerns play out, with Federal Courts recently upholding CMS’ hospital price transparency rule, it is time for everyone to start executing, which raises the third big concern, that implementing and maintaining these new requirements will be complicated and effortful. Rest assured, that really doesn’t have to be the case. Sure, it’s a heck of a time with everything else going on to have to do this, but the administrative overhead and project resource commitments need not be overly complicated. There may be some strategic evaluation you want done, but the work at hand doesn’t necessitate a large task force, a lengthy schedule, or high costs.

This is a bit simplistic, but essentially the work needed to meet requirements:

This work and the Jan 1, 2021 deadline is the first step toward improved visibility and understanding of our healthcare costs and options. With approximately 20% of US GDP spent on healthcare, and with the cost of care continuing to rise year over year, it certainly won’t be the last.

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