What if hospitals do not comply with the Price Transparency Rule?

From January 1, 2021, hospitals all across the United States (US) will have to comply with the new price transparency rule. According to the new rule, hospitals will be required to maintain a list of all the standard charges for the services available to patients.

The price transparency rule has gathered much attention since last year as both private and public sector hospitals argue that disclosure of the rates would be a direct violation of the First Amendment.

Thus, an appeal was filed by the hospitals, including the American Hospital Association (AHA) against the order of the court to delay the implementation of the rule till the on-going pandemic is over.

However, if hospitals do not comply with the price transparency rule, here is what is likely to happen:

A task force would be made

There would be a need to determine an overall compliance plan to make sure that the hospitals, both in the public and private sectors are following the orders of the court and implementing the new price transparency rule. Once a strategy is developed in this regard, there would be a need to further break it down into smaller fractions to make sure that it is being followed across all the services industry and not just by a few.

Help connect with the organization’s EHR

There will be a need to make sure that the pricing data and information are present to be published publicly by both the private and public hospitals. There might be professional help required to expedite this process of collecting data together and making it available for patients and the public. If they find an issue in this process of price estimation then there will be a need to develop a subgroup that will serve as a solution for providing data in an efficient and smart way.

Help in identifying if there is a need for a self-service estimator

According to the recent data collected in this regard, the number of patients that have been generating their own estimate have grown up to 50% in the year 2020. Implementation of the self-service estimator might become more efficient when compared to other services charges.

The criterion for CMS is required to have the following tools:

• The estimates should be generated in real time.
• It should be advertised on the website of the hospital.
• It should be made free for anyone to use.
• Make a strategy for efficient communication

It is important that a full-fledged policy be made for educating patients about the price transparency rule. It is also important that patients and the public, in general, are educated about the policy for a better understanding of what it intends to do. Patients need to know about all the factors that influence their final hospital bill so that there is no ambiguity.

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