How to Correctly Follow the CMS Mandate – Publishing Charges for Customers

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By Brad Olin

As hospitals begin to adjust to the Center for Medicare and Medicaid Services’ (CMS) new price transparency mandate, many providers are still concerned about how their patients may perceive their online posted standard charges. 

As everyone is probably aware of by now, as of January 1, 2019, CMS has required all hospitals to post their standard charges online in a machine-readable format. 

Although this mandate was instilled to help create a more patient-centric experience, many providers have focused more on meeting the bare mandate (only posting the list of charges online) rather than going the extra mile by providing a tool for patients to determine their true out-of-pocket costs. 

The key is to present this information simply and clearly to ensure that patients understand the significance of the charge list. Sure, some patients may still have questions about the significance of those standard charges, which is why it’s crucial that patients know who to contact without too much digging around the website. 

In fact, according to a 2018 webinar survey, 57% of the buyer’s journey occurs online before engaging in sales. Pair that with the fact that the average online attention span of customers is only 8 seconds long and now you have a compelling reason to develop an online estimate tool that is engaging, user-friendly, and most importantly, accurate. 

Before a hospital can develop a plan for presenting their standard charges, hospitals need to ensure that they are providing all of the necessary information to the patient. 

In an effort to provide continuous support to the healthcare providers by delivering a patient-centric experience, CMS recently released a FAQ list comprised of items that were added to the CDM list. In this FAQ list, CMS provided further detail on the items that need to be included, such as drugs and biologicals, for each diagnosis-related group (DRG), regardless if a hospital is currently involved in their own state-wide price transparency mandate. If a hospital does not provide all of this information online to the public, they will not be in compliance with the law and are subject to face future penalties.  

After providers have fully implemented all items necessary to satisfy the current mandate, the next step is to present this data in a manner that is engaging, clear, user-friendly, and of course, accurate. Try collaborating with your internal marketing team to develop a layout and strategic message that resonates clearly with your patients of all educational backgrounds. 

Again, it’s all about creating a more patient-centric experience for the consumer. 

Ask yourself “How can I deliver exactly what the patient wants to see in as few clicks as possible? What does the patient want to see?”

Here are 2 tips to boost your online presentation: 

  • Make it engaging and simple —>Don’t treat this webpage like other pages on your website that are more content heavy. Keep it simple (in language and appearance) by creating a tool that makes the user feel like they’re interacting with the price tool, rather than simply clicking on a series of hyperlinks.  This tool should also provide multiple contact methods (phone, online chat, text message, etc.) for patients to get in touch with an internal representative who can help patients with any insurance-related questions they may have. 
  • Make the language reader-friendly —> The last thing a patient wants to see is multiple paragraphs packed full of medical jargon; instead, use laymen’s terms to help explain the CDM charges while simultaneously framing the message in a way that relates to the patient. For example, try saying something like “we know financial language can be confusing and we are here to help you better understand your bill.” 

Going forward, the best way for hospitals to stand out from their competition is to go the extra mile by offering a cost estimator tool for patients to determine their true out-of-pocket costs. 

As we’ve seen so far, most providers are only looking to satisfy the bare mandate by posting their CDM list, but that only solves half the problem; patients need a way of receiving estimates so they can be more in control over their financial responsibilities. That’s why it’s crucial that hospitals act quickly to develop their own unique cost estimator tool before CMS decides to add items to their current price transparency mandate. 

Brad Olin is the Marketing Communications Specialist at PMMC, a leading provider of revenue cycle management solutions for hospitals and healthcare systems across the U.S. Brad offers a modern outlook into the evolution of the healthcare industry and general practices used to grow an organization’s revenue integrity.