Improve your practice price transparency to empower your patients

1

• Improve your practice price transparency to
  empower your patients

2
Improve your practice price transparency to
empower your patients
Lack of transparency regarding expenses of health
care services hinders the patients ability to
make true value-based decisions. Health care
markets are prevented from operating efficiently
due to lack of complete, accurate and timely
information regarding cost of health care
services. Meaningful price transparency can
empower patients to make informed care decision
and it can also help lower healthcare
costs. Resources should be developed to tackle
patient confusion and poor health literacy. This
can assist patients in understanding complexities
of health care pricing and persuade them to seek
information about cost of health services that
they receive or are planning to receive. All
health professionals and entities should make
information about prices for common services and
procedures readily available. Information about
cost of their professional services should be
communicated by physicians to individual
patients, taking into consideration the insurance
status of the patientsuch as self-pay,
in-network insured, or out-of-network
insured. Complete information regarding plan
benefits and real-time, cost-sharing information
associated with both out-of-network and
in-network service provider services or other
plan designs which may affect the patient
out-of-pocket cost should be provided to plan
enrollees or their designees by health plans.
Price and quality transparency for patients and
physicians should be facilitated by health plans,
public and private entities and other stakeholder
groups by working with each other. Processed
should be in place to ensure accuracy and
relevance of information provided by entities
promoting price transparency tools. All-payer
claims databases should be strengthened and
supported.
Medical Billing Services in Oregon
3
Improve your practice price transparency to
empower your patients
Features that assist in facilitating price
transparency for physicians and patients should
be included by Electronic Health records (EHR)
vendors. Dependency of health care financing
system on complex arrangements between and among
employers, third-party payers, providers and
patients has resulted in lack of transparency in
health care pricing and costs. These arrangements
can make it difficult to spot accurate and
relevant information regarding costs associated
with specific medical services and procedures.
For example, contracts offered by payers to
providers frequently delineate contracted rates
as proprietary information. Outdated directories
or confusion about multiple plan contracts make
it hard for patients to determine whether a
physician or other provider is in-network.
Pricing also varies based on where the service is
performed, which can affect the cost, along with
patients out-of-pocket costs. Value-based care
decisions require not only cost but quality
information. It is a hard task to integrate cost
and quality information in a usable format in
transparency efforts. Metrics of quality is still
lacked by many care services.
Medical Billing Services in Oregon