One health system provides a look at its decadelong experience with price transparency.
Hospitals and health systems are seeing the value in guiding consumers through their financial responsibilities not only to give patients a better experience, but to increase the healthcare organizations' front-end collections and revenue. Because of this, hospital price transparency is becoming more widespread, from publishing prices online to calling patients pre-visit.
Sharing prices with consumers isn't just a trend, as Memphis-based Baptist Memorial Health Care has realized. The health system has been using price transparency with its consumers for more than a decade using its Expense Navigator, an out-of-pocket medical cost estimator tool that Baptist Memorial developed and built in-house over the course of many months, using existing resources and employee hours.
When Baptist Memorial first launched the Expense Navigator 10–12 years ago, Baptist Memorial Health Care Executive Vice President and CFO Bill Griffin says the health system aimed to accomplish three main goals: Helping patients understand their out-of-pocket liability; streamlining the electronic registration process; and improving electronic patient bill pay.
"That's been very successful for us over this period of time," Griffin tells HealthLeaders.
The health system has learned a lot over the years, he says, and he shares how it achieved the three goals.
Goal 1: Help patients understand their out-of-pocket liability
Using price transparency to help patients avoid surprise medical bills only works if the estimates are accurate.
That's why the online data that the Expense Navigator pulls from is as detailed as possible. Griffin says they've expanded the estimator over the years to include about 90% of the procedures the hospitals perform, and certainly all the ones they perform regularly.
"We're going to take a look at that going forward, just to see if we need to fill in those gaps, but by far the majority of everything is in the navigator right now," he says.
In addition, the tool generates cost estimates that are specific to each hospital in their system, with the exception of those that were newly added after a recent merger and a newly built hospital that will open December; those new hospitals will be added soon, Griffin says.
"The pricing is unique to each of our hospitals," Griffin says.
Instead of generating an average for entire system, which includes more than 20 hospitals across three states—the price estimates are hospital-specific, taking into account each hospital's specific charge structure.
A team of employees also updates all the charge information annually and test frequently for accuracy by running sample procedures and insurances through the tool to ensure that it's as close to the actual price as possible.
Griffin also says the team continues to innovate by brainstorming ways that the tool can be as helpful and accurate as possible for patients.
One of these brainstorming sessions resulted in a feature on the tool that was inspired by the virtual "shopping carts" on websites like Amazon. After searching for a procedure, Baptist's Expense Navigator displays other possible expenses that may accompany it.
For instance, a search for outpatient miscarriage care at Baptist Memorial Hospital-Golden Triangle not only yields an average charge for the procedure itself, but also a note that there may be additional charges related to supplies, medications, and lab tests.
Griffin says it gives patients a heads up about other possible costs and opens the door for patients to have conversations with their healthcare provider to make sure they fully understand the procedure they're about to have.
Goal 2: Streamline the electronic registration process
Although the Expense Navigator is consumer-facing and lives on Baptist Memorial Health Care's website, patients aren't the only ones who use it. The tool has also helped the system to improve the electronic registration process, allowing staff to use the tool to let patients know what they owe during pre-registration.
"After we implemented it, we realized not only was it good for the patients but it's a good tool for us to use internally," Griffin says.
So, they trained existing staff members on using the tool during the patient registration process.
During this training, they ran regular feedback sessions with staffers who were using the tool to make sure they knew how to use it, says Liz Tucker, system director of patient access services. The health system used that feedback to make the tool easier to use, such as by adding keywords to refine the search function.
Now, the Expense Navigator allows staff to provide patients with an estimate for their care, and registration staff can also help set patients up with a payment plan if needed.
Pre-registration staff can also check to see whether a patient qualifies for any third-party insurance, like Medicaid, says Tucker.
"Anytime someone is scheduled we're calling to get them pre-registered by telephone," she says. "Part of the pre-registration process is to complete everything we can prior to the patients' arrival."
Goal 3: Improve electronic patient bill pay
Baptist Memorial Health Care wants its online patient financial experience to be as easy, smooth, and non-frustrating as possible, Griffin says.
For instance, the Expense Navigator is searchable by procedure name, keyword, or DRG code. Users can specify whether they're looking for information about an inpatient or outpatient procedure and which hospital within the system they'll be visiting. Results first display the average charge for a procedure; users can then use the tool to generate their out-of-pocket estimate based on their insurance information.
There's a link to the Expense Navigator right on the health system's homepage, and the tool also links directly to its financial assistance information and policy.
"We've just tried to make it as patient-friendly as possible," Griffin says.
For instance, the Expense Navigator site links to Baptist OneCare MyChart, the patient portal for its EHR system, where patients can pay their bills online. The site also includes contact information for the business office, which can help with payments and payment plans, too.
Data also shows that the tool is easy to find and use. The system's web marketing team notes that in 2018, the system averaged about 2,500 visitors a month to the site, and they've seen an 87% correlation between unique events and page views; in other words, if you land on the page, there's an 87% chance you'll actually use the tool.
Alexandra Wilson Pecci is an editor for HealthLeaders.
Use price transparency tools during pre-registration to give patients estimates ahead of their visit.
Educate patients about payment options to improve collections.
Ensure estimate accuracy with data that's hospital-specific and frequently updated.
Make payments easy by linking the price estimator to other online resources, like financial assistance information and online bill pay.