Shopping online for cars of a specific year, make, model, and total cost is easy. Shopping online for healthcare services is hard. For example, why can’t we accurately estimate the cost of a hospital procedure as easily as a new set of wheels?

Healthcare consumers today can review their insurance coverage online, call their insurer’s customer service team, or chat with the hospital billing department to predict the expected costs for care during a hospital stay. However, many consumers have reported that their medical bills have often included unexpected costs never factored in or communicated to them upfront, making their estimate somewhat or entirely inaccurate. The frustration and ensuing impact of these surprise, bigger invoices causes payment delay or no payment—creating a negative revenue cycle impact for the billing providers. It’s a circular issue and headache for everyone. But it doesn’t have to be.

In this blog, we’ll explore cost estimate tools as a component of the hospital payment process, the benefits to providers and consumers for implementing them, and next-step recommendations to help providers adopt these changes.  

Price estimator tools can keep hospitals in compliance

To help increase the chances that consumers are able to pay their bills on time, they first have to be armed with tools that help estimate, compare, and choose care from the provider that works best for them. Unlike cars, the consequences for defaulting or not making payments for healthcare can be far more severe and costly.

Recently, price transparency rules were introduced by the Centers for Medicare & Medicaid Services (CMS) to help consumers know the cost of hospital procedures before receiving them. To be compliant, hospitals must post standard prices for at least 300 shoppable services and post them online in an easily accessible way. The price lists can include pricing for x-rays, imaging, lab tests, knee replacements, colonoscopies, and more.

One way for hospitals to support price transparency efforts and eliminate surprises for consumers is through the implementation of cost estimate tools posted on their websites. This capability in the hands of consumers gives them the ability to estimate how much service could cost out of pocket and/or after insurance to avoid surprises and choose a provider that falls within their budget.

Here are some expected benefits of accurate cost estimate tools.

Increased Patient Satisfaction. Hospitals and healthcare systems pay close attention to the quality of care, safety, and experience, as these are critical components of patient satisfaction ratings. To take your ratings to the next level, include the cost of care as a factor of the patient experience. By focusing on providing accurate cost estimates and reducing confusion with billing, you can help your patients feel more comfortable about their financial responsibility and have a better experience under your care.

Stronger Patient Loyalty. As a component of patient satisfaction, hospitals can increase patient loyalty by helping them understand their financial responsibility ahead of time, so they can focus on what really matters – recovery. In fact, it pays – literally - to have a high-quality payment system. Consumers are likely to switch providers over a poor payment experience. Bottom line, if you want patients to return to your hospital and encourage their friends and family to do the same, make sure there are no questions regarding how much their care will cost.

Timely and Predictable Payment Collection. Inaccurate assumptions about total costs can hinder a consumer’s ability to make full payments when they are due. In today’s reimbursement landscape, it can take providers more than 30 days to receive payment for their services. Helping your consumers be more prepared and informed about costs will result in more predictable streams of revenue for hospitals.

Next steps for providers

If your organization is considering the design and implementation of such tools, here are a few recommendations for what you can do next and how Propeller can help you along the way.

Make Cost Estimate Tools Easy to Find and Use. Make it easy to find this tool on your website, paying careful attention to website accessibility features and design. The pricing information provided should be easy to access, with little to no personal information required, and use simple language.

Engage and Educate All Stakeholders. All staff and providers, not only those in front-end or billing departments, should be educated on cost estimate tools and be prepared to have financial conversations with patients. Providers who make cost part of their consultations can help patients understand the balance of cost, quality, and outcomes in a manner that takes into account a patient’s financial situation.

Incorporate Quality Measures. The shift to value-based care is hyper focused on providing the highest quality care to patients and improving their health outcomes. Include data on quality and outcomes so consumers can know they are getting a good price and quality care. If two organizations charge nearly the same for the same procedure, quality and outcome could be the patient’s deciding factor on where to schedule their service.

 Maximize Accessibility for All. Self-service tools, such as cost estimators, are a great way to engage and educate your tech-savvy consumers. However, there are plenty of consumers who need care but may not have access to the internet, or the knowledge required to use your tool. To maximize consumer adoption of your tool and get more patients to schedule procedures, make sure that your cost estimates are easily accessible online and offline.

Aligned Incentives: How Employers, Payers, and Providers Can Partner to Fix Healthcare

The Final Word

Shopping for healthcare could be as easy as shopping for a car, and some organizations are moving in that direction by offering cost estimate tools. Unlocking and sharing pricing information for health services and procedures enables consumers to prepare for and manage their costs from beginning to end. The better your organization can help patients prepare for all costs associated with their care, the more likely you’ll receive on-time, full payments, and patients will leave satisfied, prepared to make payments, and likely to recommend your organization to others.

If your organization wants to improve an existing cost estimate tool or implement a new one, Propeller can help. Reach out to us for support with optimizing payment systems.

Contact Us