Price Transparency in Health Care

One of the many advantages of online shopping is it allows consumers to compare prices and find better deals.

Price transparency is important in any market, including the healthcare market. When patients know or have access to price information, they can choose the most cost-effective and affordable health care available. Price transparency also can, in theory, drive prices down as providers compete for the market share. 

If you are an employer looking for an effective means of cost control, knowing how much hospitals charge for certain procedures will help you and your employees make better financial decisions. 

The need for price transparency is so immense that the government has taken steps to resolve this issue. 

In November 2019, the administration announced a new health care price transparency rule that requires health systems to explain how much a medical service would cost before a patient receives treatment. It would also require hospitals to tell patients, prior to treatment, how much their insurance plan would pay, and how much they would owe out of pocket. 

This rule is scheduled to go into effect in January 2021, but many believe that it will only have limited effects as the rule still needs to be modified to make it more useful to consumers and employers. 

While you are waiting for this rule to come into effect, you will be happy to learn that you already have excellent help available to assist you in managing your costs. That help comes in the form of Accarent Health. 

Ahead of the Curve

Accarent Health is revolutionizing the health care payments structure and marketplace by empowering employers, patients, and plan administration. They are providing the transparent pricing of medical procedures at top-rated hospitals to help you make informed healthcare decisions. 

This e-commerce marketplace offers fixed, transparent bundled rate pricing options directly to employers, patients, and plan administrators with no annual membership fees or volume requirements. 

Corinne Burns, Vice President of Client Services shared Accarent Health’s mission in our recent podcast interview. She said, “Our mission at Accarent Health has been to redefine the health care distribution and provide information access by creating a digital network that provides our members with striking price transparency and cashiers assistance.”

Price transparency is essential in healthcare, especially now that consumers are spending thousands on insurance and medicine. 

Accarent Health answers the need for price transparency by offering access to pre-negotiated bundled prices for over one hundred and twenty complex procedures, anything from orthopedic surgeries to gender affirmation, bone marrow transplant, and complex cancer treatments. They are even expanding heavily in the behavioral health segment. The bundles include all facility services, supplies, and equipment to perform the procedure, and any professional services deemed necessary by the physician. It also covers any services associated with the procedure for 30 days post-discharge (60 days for some transplants and extended treatments). Revisions and readmits, within this 30-day bundled period, are also included in the original bundled price.

Corinne mentioned that they did some heavy lifting to work with medical centers across the U.S. to provide consumers with a clear price and service metrics and making these available on an online platform. All the procedures are available on the company website. 

What makes Accarent Health unique among the many companies advocating for transparency in pricing and procedures? According to Corinne, “Accarent is focused on building a network of high-quality hospitals and offering access to those centers especially in complex procedures typically performed on patients. We also take that transparency to the next level. So, we provide the patients and payers with clear inclusions and set parameters so that there is never a surprise there. So, what that means is a payer can evaluate their options more clearly on our website.”

If you are a self-insured employer who oversees the health care of your employees, you will appreciate what Accarent Health does. It ensures that what procedure fee your employee sees and picks on the website is just what you are getting on your bill. 

Improving the Health Care Payment System

One of the ways Accarent Health is disrupting the healthcare ecosystem is in its payment system. Corrinne explained that in many healthcare businesses, the ultimate payer is typically disconnected from that decision-making process. 

“As an employee, you may not even know that your employer’s at risk or your employer is funding your care. The best comparison that I can make outside of the healthcare industry is maybe when you are out for corporate dinner, event employees or attendees tend to be more free spenders than when they are paying out of pocket. And the vendors can also upcharge when they know that there’s a large pocketbook supporting the cause and there is going to be less oversight. Now, what exacerbates that even further in health care is that there is typically no way to even know what the cost is upfront for the services being requested or needed. So, this creates a great opacity and inability to make informed decisions by those decision-makers.”

This is a great call out. As an employer, you need to be informed of all the costs of any medical procedure your employee needs. Having a list of bundled rate pricing options means you know what to expect to pay, and there are no surprises. 

Accarent Health is doing a wonderful job of revolutionizing healthcare and driving it towards consumerism.

To listen to my full interview with Corinne, visit https://outcomesrocket.health/accarent/2020/03/.