This Week Health

A survey revealed that few are complying with the transparency rule. Either it's too complicated to understand or organizations just don't think it is worth the effort. Yes, there are penalties but they don't seem to be enough to coax organizations into compliance. Might be time to rethink this one. Right intention, wrong implementation.

Transcript

Today in health it price transparency. We're looking at a new survey, just 14% of hospitals are compliant with price transparency. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health channels dedicated to keeping health it staff current. And engaged. We want to thank our show sponsors who are investing in developing the next generation of health leaders.

Gordian dynamics, Quill health Taos site nuance, Canaan, medical, and current health. Check them out at this week. health.com/today. All right. This Thursday, February 24th at 1:00 PM. We have an incredibly interesting webinar. It's interesting because I don't like webinars and I, when I started to do webinars, I decided we are going to do them a little different. One of the things we do.

Is when you register, you put your questions in, then that way I can get them in front of the people who are going to be on the sh on the webinar. , head of time, we can get really good answers for you. , the other thing is if we don't get to your questions, we answer them after the fact and put them on the, on the website.

Where the on-demand webinar is, so you can get the answers to those questions. So we're going to answer your questions. For sure. The other thing is I don't take topics that I, that are dull and boring and this one it resonates with CEO's and that is, , moving your EHR to the cloud specifically, though, not epic hosted. We're talking about epic on Azure for production.

And we have two health systems that have done that. We have one, a person with serious health care who has been a part of making that happen. That's Doug McMillan. And I'm looking forward to, , looking forward to this discussion. , cone house St. Luke's university health network out of Bethlem Pennsylvania, both gone to, , epic and Azure. And they're going to share their journey with us this Thursday, February 24th, 1:00 PM. Go ahead, hit our website and , you can register there.

All right, let's hit this, story, and I'll probably just comment as we go through it. Rather than just read a wall of text to you. So a survey finds just 14% of hospitals are compliant with price transparency. The biggest noncompliance was non posting or incomplete posting of all of the negotiated prices for each item and service.

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But that's not happening. So let me give you the, the surveys from patient rights advocate that org. And I give you that 14.3% number, and that's a 14.3% of a thousand hospitals that were looked at. About 38% of the hospital's survey posted a sufficient amount of negotiated rates. But over half of them were not compliant in other criteria of the rules, such as rates by each insurer and named plan.

spitals were in compliance in:

Was just $12,000 per hospital, according to the report. The most prevalent emission tagged as noncompliance was not posting or incomplete posting. Of negotiated pricing, as we talked about earlier. , you know, as I read that it's a business decision. The penalties aren't high enough for this too.

Have any impact on the profits of these organizations? In fact, probably the opposite is true. If they did post this information. It would make it easier for their competitors. To position themselves against these health systems and not only these houses, but other health systems are making that same choice. They're saying, either what's the minimum bar or let's just not do this at all. We have so many things going on and if this is all this going to cost us this amount of money, just write the check.

I think that's what's happening. , again, I'm not talking to anybody in the know on this. I'm just reading into it and using my experience to say. I think it's just a business decision flat out the penalties aren't enough to really matter. And I'm not even sure this administration is going after them. So at the end of the day, there's almost no penalties.

All right. So it goes on almost 86% of all hospitals in the survey did not post complete machine readable file of standard charges. Okay. So part of that, part of the rule that I forgot to mention is the, the file was supposed to be in machine-readable format so that it could be pulled in by various tools and use for comparison.

It's a requirement of the rule and a majority don't 86%. Don't have it. A similar number about 85% failed to provide the national drug codes. And associated prices for each of the drugs and pharmacy items offered. Okay. Meanwhile, 62% did not publish a sufficient amount of negotiated rates. 58.6 did not publish all payer specific negotiate charges.

, and, these numbers are going to continue on and on like this. This is a business decision. People looked at this and said, what's the pellet. Let me see what the penalties in here, because the penalties are not much.

So here it is the penalty for non-compliance. As a maximum of $300 per day. But the JAMA study said that the cost of disclosure of negotiated rates could be greater. , than any fines. All right. So again, I think it's a business decision. Let's go on to see what some people said about this price. Transparency is crucial first step towards more transparent competitive healthcare system. The authors wrote today because of hidden prices and lack of functional market.

The United States. Is paying double that of other developed countries for our healthcare and with worse healthcare outcomes and shorter lifespans competition lowers costs. Of care to employers and workers. Allows for higher wages and results in more globally competitive us economy, only with true compliance with both price, transparency, laws, and regulations.

Well such long-term goals be realized. Again, this comes back to the age old, meaningful use worked. In that. Today, when you go to most hospitals, they're on some sort of digital platform. They're on some sort of EHR. They are a digital healthcare system. Right. So it had the incentives, it had the carrots, it had the sticks, it had the disincentives for those who did not do it.

, and they were great enough that it caused just about every health system to do the project. These penalties. Aren't great enough to cause anyone to do anything. And if the, if the enforcement isn't there. , it just comes down to do we have the check to write. And is the check less than what we would have to do in order to put all this work together, which is a fair amount of work.

So, unfortunately I think the technology's there. I think the opportunities there, I would love to see this happen across the board. I think it's great. We looked at a little while ago, we looked at a tool that was pulling some of these.

, some of this information in, and it was fascinating, quite frankly, it showed the disparity from, from a health system to health system on certain procedures. That are termed shoppable services. So me as a consumer could look at it and say, you know what, I'm going there for my MRI. Because it is a lot cheaper than going over here.

You know, my soul went on, this is, it's not a technology problem. We can do this. We're ready to do this. We can actually do this really effectively. And we can tie into some of the big tech and some of the startups that are. Pulling this information together for the good of the consumer, putting it in front of the consumer. I like the potential outcome of this.

, potentially the rule is not well thought out or it's not being implemented well, , for this many health systems to choose to be noncompliant, there has to be something in the law either. , the penalties have to be greater. The incentives have to be higher or the business case or the, the benefit to the consumer and the communities that we serve has to be more clear and everyone agree to it.

So for whatever reason, this rule is not really taking hold. And again, not a technology problem. We're ready to go. Sinus up coach put us in we'll we'll make this work, but at the end of the day, somebody else has to put all those, those prices together. It's a fair amount of work to be sure. So, again, I think we need to look at the rule and figure out what is wrong with the rule, what is wrong with the implementation of the rule and get this thing, right?

Because I think this is an important step. And really maintaining the cost of health care. If not bringing down the cost of healthcare. That's all for today. If you know someone that might benefit from our channel, please forward them a note.

They can subscribe on our website this week, health.com or wherever you listen to podcasts, apple, Google, overcast, Spotify, Stitcher, you get the picture. We are everywhere. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders, Gordian dynamics, Quill health towel, site nuance, Canon medical, and current health. ???? Check them out at this week. health.com/today.

Thanks for listening. That's all for now.

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