Price Transparency for Rural & Community Hospitals
In this age of consumerism, patients want to know the cost of services from their provider, not just the insurance company. However, it’s now more than a patient desire – it’s a requirement for all hospitals, including rural & community hospitals.
Beginning on January 1, 2021, the Hospital Price Transparency Rule by the Centers for Medicare & Medicaid Services has mandated all U.S. hospitals to annually post online their standard charges for goods and services in two formats:
- A comprehensive machine-readable file
- A consumer-friendly display including at least 300 shoppable services
Hospitals neglecting to adhere to these requirements may receive CMS violation notices and face daily fines: $300 for institutions with up to 30 beds and a charge of $10 for each bed for hospitals with more than 30 beds.
Our team has partnered with rural & community hospitals to create fully compliant price transparency files. Using our expertise in price transparency and the rural marketplace, our experienced rural and community healthcare consultants can help hospitals improve their price transparency.
CASE STUDY
See how Stroudwater Helped Alleghany Health Remediate their Price Transparency Issues.
Improving Price Transparency in Rural & Community Hospitals
Developing or modifying price transparency can be a complex process. Many rural & community hospitals struggle to identify 300 shoppable services for inclusion in the list. Additionally, it can take a significant team effort among many departments in the hospital to develop the final transparency documents. When embarking on this journey, whether by choice or because CMS sent a warning, hospital leadership may find themselves asking questions like:
- Who can help to remediate the issues?
- How much would Remediation Cost?
- Is 90 days (or however long the time received by CMS to remediate) enough time to complete the project?
- How will the Rural & Community Hospital withstand the fine if it came to that?
Our team is here to help hospitals update their price transparency affordably and timely. Our two-step process helps rural & community hospitals correct any issues and improve price transparency to have a listing that meets CMS’s requirements.
Develop a Consumer-Friendly Display with at Least 300 Shoppable Services
We will also help ensure that the price transparency list follows standard naming conventions and includes the proper data elements.
- Using the hospital and clinical chargemasters
- Working with Clinical teams for associated ancillary services
- Analyzing payor contracts for payor-specific negotiated charges to be listed for each service
- Developing an Excel model to be posted on the website
- The 70 CMS-specific shoppable services that are provided by the hospital.
- Associated ancillary services provided by the hospital to reach the 300 shoppable service items.
- All locations operating under a single hospital license.
- All required data elements.
- Posted on a publicly available website.
- Easily accessible.
- Digitally searchable.
Develop a Machine-Readable File
We will also help ensure that the machine-readable file:
- Includes all standard charges for all items and services for all locations operating under a single hospital license.
- Is posted on a publicly available website.
- Is easily accessible.
- Is digitally searchable.
- Is updated at least once annually.
- Follows a standard naming convention.
- Contains the correct data elements.
Comprehensive machine-readable files and shoppable service files contain similar yet unique information. Having a partner like Stroudwater Associates to help modify or develop price transparency in a rural or community hospital can help ensure the CMS requirements are met in a timely fashion.
