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 Today in Health IT, we are discussing Ohio becomes the first state to require hospitals to publish prices. My name is Sarah Richardson, and I'm president of community development at This Week Health, where we host eight set of channels and events dedicated to transforming healthcare, one connection at a time.

And I'm joined by Kate Gamble, managing editor here at This Week Health. Kate, welcome to the show. Thank you, Sarah. So welcome, first of all, to today's podcast, but today we are exploring a significant development in healthcare policy where Ohio has become the first state to mandate that hospitals publish their prices.

And this move aims to enhance price transparency in healthcare, which is a topic that's been gaining momentum nationwide. Yeah. And it's a topic that. Most, if not all, of us can relate to. Patients are being besieged with five and six figure bills due to surprise billing, murky price schedules, and hidden fees, and they're tired of it.

Ohio's legislation seeks to enforce these requirements at the state level. I love this, and I think about how important this is as a patient, when you can literally not only shop by quality, but shop by price and make your own decisions about where you're going to want to get your health care. And we're going to look at five different things about this legislation and discuss the implications for healthcare CIOs and the broader industry. Absolutely. So first and foremost, the law mandates that hospitals publish pricing information for at least 500 shoppable services. So these are services that patients can schedule in advance, such as elective surgeries or imaging tests.

For CIOs, this means ensuring that the hospital's IT systems can accurately compile and display this data in a consumer friendly format. Interestingly, we recently published a keynote where Chad Brizendine, who's the CIO at St. Luke's Health Network, Talked about a transparency tool that they're adopting.

Give that a listen as a side note. Yeah, great point, because the pricing information has got to be available in a comprehensive machine readable file, essentially. This requirement ensures that third party developers and researchers can access and analyze the data effectively. So if you're the CIO, you're going to need to collaborate with your IT team to create and maintain these files, adhering to specified standards, and over again, this goes back to data quality, data lineage, the ability to make sure that people trust the source of the information that is feeding systems that are advancing the ability to connect more effectively with your patients.

And another highlight looks at noncompliance and the significant consequence that it carries. And this is so important. So hospitals that fail to meet transparency requirements are prohibited from collecting medical debt from patients and from filing negative credit reports against them.

So this adds a financial and reputational incentive for hospitals to comply. So as a CIO, you need to prioritize the implementation of these transparency measures to avoid these penalties, which can really add up. It can add up, for sure. And the Ohio law is aligning with the federal regulations, but also introducing state level enforcement.

The dual layered approach could serve as a model for other states in aiming to enhance compliance. And, again, as a CIO operating in multiple states, it's crucial to stay informed about both federal and state specific requirements to ensure uniform compliance across all of your facilities. Yeah, that's really important.

And another key piece of this is that it addresses the issue of price estimates. So in the past, hospitals could provide estimated costs, which often led to discrepancies between expected and actual charges. And sometimes these discrepancies were huge. So the new law emphasizes the need for accurate upfront pricing to prevent unexpected medical bills.

And if you're the CIO, this means you have to work closely with finance and clinical teams to ensure the pricing data reflects true costs. And the law brings up even a broader conversation, Kate, about the price transparency in health care. While Ohio is the first state to take this step, It raises the question, will other states follow suit and if so, how are CIOs and hospital administrators going to start preparing now by reviewing their current pricing transparency policies and identifying areas for improvement?

And what's fascinating to me is even if you work in your own hospital system, it is really hard. to find out how much your care is going to cost when you need a procedure or something done, even in your own health care system.

Yeah, that really boggles your mind, we need to consider that patient perspective.

Price transparency can empower patients to make more informed healthcare decisions, but are hospitals prepared to field questions from patients who may now compare prices between hospitals and demand justification for cost differences? CIOs and hospital leaders need to think about how to educate both patients and staff about what these prices truly represent.

Exactly. So let's. discuss how this impacts hospital finance teams, too. In addition to your I. T. considerations, this law could push hospitals to rethink their pricing models. If a hospital's pricing structure is now under public scrutiny, will they need to adjust their rates to remain competitive? And the technology teams have to work closely with finance and Revcycle to ensure that their pricing strategy aligns with both regulatory requirements and market expectations.

Exactly. And we can't forget the impact on insurance companies. So with more transparent pricing data available, insurers might start using this information in negotiations with hospitals. So we could see more payer scrutiny over why certain procedures cost significantly more at one facility compared to another, which I say it's about time.

So this might also shift the balance of power in payer provider negotiations. Making it more critical for CIOs to ensure accurate and defensible pricing data. Yeah, that's a great point. It takes me back, though, to the space where quality and quality outcomes are huge in making a decision about health care.

But most people don't make their decision about where to go get their health care based on the quality and the outcomes. They go based on convenience of location. In some cases, that may be the only game in town, truly. So you also have to layer in. any kind of legal implications, because if hospitals don't comply, Ohio's law has financial consequences, and it's beyond fines and penalties.

Could hospitals face lawsuits from patients or advocacy groups demanding greater accountability? And compliance isn't just about technical issues, it's a legal and reputational One as well. I am hopeful. Okay, in this ideally trend that will occur that a patient can truly make a decision about where to get a procedure based on how much it costs, what kind of outcomes can be expected from that, and then how they plan for that accordingly.

So they don't go into any kind of medical debt or level of bankruptcy because they can't afford something that they may need and be surprised after the fact.

I'm hopeful too, that that's the direction in which we're going, and so CIOs and compliance officers, you need to be collaborating now

to ensure that price transparency efforts align with both state and federal regulations. Hospitals need to develop a long-term strategy, not just for publishing data, but also managing the public's response to it. We talked yesterday about the text, the CEO program at Banner Health. And it showed the criticality of having open channels for feedback and having transparency.

I want to see the texts, Kate, that come through when someone gets mad about like a bill, like texting the CEO, like imagine, and this would be interesting because Banner's primarily Arizona. So imagine if they're getting texts today about the cost of their care, and then all of a sudden transparency comes in.

Will that ameliorate some of that type of feedback? That'd be an interesting one for us to follow up on with the banner team since we have access to them. And you're listening to this today, what's a takeaway to be considering? As a technologist, do your IT systems have the capability to manage and display accurate pricing data?

HIT executives have to evaluate whether or not current systems can handle this demand. And then integrate data for multiple sources and present it in a compliant format for patients and regulators. That's going to take time to work through in your governance models. And then separately, how does price transparency affect your hospital's competitive positioning and payer negotiations, which Kate touched on?

This is beyond compliance. Price transparency has strategic. Implications. The technology teams must assess how their hospitals published prices compared to competitors and how payers might use this data in contract negotiations. It's going to force executives to think about the business impact of transparency and how technology can support competitive pricing strategies.

Yeah, those are great questions, great fodder for conversation. And ultimately, Ohio's law is just the beginning. So we saw in the article that Hawaii, Oregon, Pennsylvania, and Washington are considering similar legislation. And hopefully more states will follow suit. And so I think we can conclude that price transparency is a growing expectation from patients, insurers, and regulators.

And so healthcare leaders need to be taking proactive steps now to stay ahead of the trend. And on top of everything else. It's the right thing to do. Not everyone has the knowledge and resources to question these claims and fight them, and to me, they shouldn't have to.

You and I often say, because it's the right thing to do, it goes back to the food is medicine programs.

And so we'll start keeping track of all the things that we are researching and sharing with our audience, because it's the right thing to do. Price transparency and food is medicine are two things that you and I 100 percent agree need to be happening. The other thing that will be interesting to track is we have a city tour dinner in Cincinnati in April, and this will be a good conversation with the table to see how it has affected it.

Their facilities and what kind of feedback they're receiving as well. And so we are hopeful this has given you a valuable set of insights into future hospital price transparency and what it means for both healthcare it and for leadership teams.

Stay tuned for our next episode where we will discuss the perfect storm facing the healthcare workforce. Eight current issues frame this challenge. Remember to share this podcast with a friend or a colleague and use it as a foundation for daily or weekly discussions on the topics that are relevant to you and the industry.

They can subscribe wherever you listen to podcasts. Kate, thank you for joining me and thank you for listening. That's all for now.