Hospitals have just a few months to ensure their prices are rational and defensible to meet the January 1, 2019 deadline.
St. Paul, MN—August, 2018—Panacea, a leading provider of mid-revenue cycle management, innovative software and enterprise-level educational solutions announced today that despite industry push-back during the comment period, the CMS Final Rule requires hospitals to publish their standard charges on their website for consumers to access.
Accordingly, Mark Spehar, Senior Vice President, Financial Services at Panacea stated, “with this requirement we urge hospitals to start now and use their scarce time wisely to ensure that they can document and defend the rationale behind each line item price in their chargemaster to meet the January 1, 2019 deadline. Additionally, they should initiate the process of publishing their CDM on their web-site along with proper disclaimers and clarifications on those instances where charges might impact patient financial responsibility. We also advise hospitals to consider analyzing their historical claims and payment data to provide additional information to consumers such as recent historical average charges by DRG and average charges and payment levels segregated between in-network and out-of-network patients, even if this information is rolled out in a later phase.”
Specifically, the CMS final rule states, “as one step to further improve the public accessibility of charge information, effective January 1, 2019, we announce the update to our guidelines to require hospitals to make available a list of their current standard charges via the Internet in a machine, readable format and to update this information at least annually, or more often as appropriate. This could be in the form of the chargemaster itself or another form of the hospital’s choice, as long as the information is in machine readable format.”
Ted Barduson, President of Panacea stated today, “as the industry leader in hospital, physician and drug defensible and rational pricing and with the recent release of our new Hospital Zero-Base Pricing® technology designed to swiftly process multiple hospitals and regions simultaneously, we are ready to assist our clients and providers during this crunch period. This technology combined with our access to current hospital and free-standing physician and provider charge data will allow hospitals to implement defensible yet optimum prices.”
In July 2018, Panacea’s hospital and physician pricing experts presented a webinar where the importance of hospitals charges was discussed along with an instructive seven step approach to prepare for the CMS proposed rule and how technology can help providers develop and maintain rational chargemaster prices. The complimentary webinar title: Debunking the Myth: Why Charges Still Matter in the Age of Pricing Transparency is available on Panacea’s Insights thought leadership platform.