Price Transparency’s Clear Revenue Rebalancing Opportunity
The potential for healthcare price transparency became more of a reality with the introduction of long-anticipated . The proposed rules would require hospitals to
The expert
Rich Bajner
Partner
Healthcare
312.583.3740
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Price transparency presents obstacles for providers, but opportunistic leaders will use the change
as a chance to clarify and strengthen revenue. ”
“
Partner
Rich Bajner
Developing a Sustainable
Digital Operating
Model
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What Providers Need To Do:
Download The Dutch Offshore Wind Market Update 2019
HHS legislation in November
Living in a more transparent world will force provider leadership to ask some uncomfortable questions. Are we concerned about our patients' response to our prices, and do we have a defensible pricing strategy? And how can we target services for pricing in both fee-for-service and value-based arrangements while weighing competitors’ presence, market payer mix, and clinical operating model readiness?
But with change comes opportunity for providers to attain a deeper view of whether they’re charging too much or too little for services, to include commoditized consumer service pricing, service line margins, and balancing pricing for higher acuity services. Such pricing evaluation will be even more essential for academic health systems and large, regional providers.
As a result, providers can no longer rely on historical revenue projection methodologies and anecdotal explanations when they miss revenue projections or embark on new strategic initiatives.
to publish standard charges online for at least 300 common services in a consumer-friendly manner. While anticipated legal challenges may impact the final rule in 2021, it is clear that meaningful price transparency is a policy priority and a trend hospitals cannot ignore.
HHS legislation in November
rbajner@guidehouse.com
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Unintended Consequences of Convenience
Proactively manage their revenue like a portfolio to be periodically examined, compared to existing strategic and clinical initiatives, and rebalanced according to performance.
Know their data as well as payers do and develop a customized revenue portfolio strategy for the future. Data analytics can help identify the root causes of a health system’s revenue changes across such areas as collections, volume, and unit reimbursement.
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Such a portfolio approach can create a single source of truth and allow leaders to fully understand current performance. It also allows for accurate projection of future scenarios, including primary drivers of revenue risk and their potential unfavorable financial impacts.