Through an automated process, the Oklahoma-based health system is generating 20,000 pre-service estimates monthly for patient out-of-pocket costs, and banking higher point-of-service collections.
Pressure is mounting on healthcare providers to establish price transparency for medical services, with high-deductible health plans driving heightened consumer savvy among patients and Trump administration advocacy.
Boosting price transparency is one of the few specific healthcare reform proposals President Trump made during the 2016 election campaign, and his support ensures that efforts to achieve price transparency at healthcare providers will continue.
"Transparency in healthcare is not going away. It is not a flavor of the month," Amy Floria, CFO at Goshen Health in Indiana, told HealthLeaders earlier this year.
State efforts to advance healthcare-provider price and quality transparency have barely gained traction at the national level. Last summer, the vast majority of states received failing grades in a report card on transparency laws published by a pair of nonprofits—the Health Care Incentives Improvement Institute and Catalyst for Payment Reform.
Health systems and hospitals seeking to rise to the price-transparency challenge can look to the country's heartland, where Oklahoma City, OK-based INTEGRIS Health has developed robust price-transparency capabilities.
INTEGRIS, which is The Sooner State's largest health system with seven acute-care hospitals and a women's hospital, was the star of an educational session on price transparency at last summer's Healthcare Finance Management Association-ANI conference.
Greg Meyers, who was system vice president of revenue integrity at INTEGRIS until his retirement in December, said the health system's successful price-transparency journey began with setting a fundamental goal. "One of the objectives early on was to establish how much services would cost for the patient."
Over the past decade, INTEGRIS has perfected the generation of accurate out-of-pocket cost estimates for patients:
- The health system began offering out-of-pocket charge estimates to patients in 2006 through the organization's "Consumer Priceline" program.
- The program has expanded from 900 cost estimates per month conducted manually to about 20,000 estimates per month conducted through an automated process.
- Point-of-service collections from patients have skyrocketed since INTEGRIS launched the health system's price-transparency initiative, rising from $900,000 in 2007 to $18 million in 2015.
"Our biggest measure of success is point-of-service collections. We're going to hit the $20 million mark," Meyer said.
At INTEGRIS, patient cost estimates are generated during the scheduling of medical procedures, which is an effective time to start engaging patients as financial partners, he said. "It's important for patients to understand their financial responsibility as soon as possible."
The ability to give patients accurate out-of-pocket cost information upfront has been a powerful market differentiator for INTEGRIS in recent years, Meyer said. "It's the value that we provide to the consumer more than the price."
Christopher Cheney is the senior clinical care editor at HealthLeaders.