Intermountain exec: Payers are doing nothing about price transparency

As deductibles and other out-of-pocket costs rise for patients, payers and hospitals have an increasing obligation to provide them price transparency, a high-ranking executive for a well-known regional hospital system told Healthcare Finance News.

Todd Craghead, vice president of revenue cycle for Intermountain Healthcare, told the publication that payers are currently doing "nothing" to provide price transparency to enrollees. That places more of an obligation to providers to do so, particularly as patients are often left with sizable self-pay balances.

The cost versus price transparency issue remains a conundrum for most payers and providers. Few states receive passing grades for price transparency, while payers often resist calls to establish all-claims databases that would provide crucial information to consumers that would allow them to more effectively shop for healthcare services. And even when individual providers want to discuss the cost of procedures with their patients, those obstacles often get in the way. Even when health plans are proactive, tools they provide to enrollees, such as price calculators, are often out-of-date and can lead to surprise bills.

For uninsured patients, Intermountain provides a 25 percent discount and 15 percent more if the amount is paid in advance. Healthcare Finance News did not say whether the discount is based on Intermountain's chargemaster price, which could be significantly higher than charges negotiated by private insurers and Medicare.

Intermountain also asks patients with high-deductible plans how they intend to pay what they owe. The organization will delay the service in cases where medical necessity is not a paramount concern and patients don't provide an answer for how they will pay.

With such policies in place, Craghead told Healthcare Finance News that collections have improved by a couple of percentage points, while the costs of making collections have declined by about one third.

To learn more:
- read the article

Suggested Articles

Humana has filed suit against the Trump administration over cost-sharing reduction payments.

The Trump administration has launched a new alternative payment model to provide upfront investments to rural healthcare providers.

Nurx raised an additional $22.5 million in funding in May. Find out why CEO Varsha Rao believes telehealth will not go back to pre-COVID-19 levels.