Transparency Is Coming

Author: Jordan Johnson

Many people have their heads in the sand regarding value-based care initiatives, but transparency is coming. The only way that data can be used to increase value and decrease spend is to have the data readily available to front line staff and patients. The industry needs the data to bridge the gap between clinical/operational data and claims data. For oncology, this is Legion’s Claim Health^®

Patients will also have a demand for transparency thru data. They want to know what things are going to cost and what their responsibility will be. This year we had chargemaster data that was required to be made available on hospital websites. Although most hospitals complied, the patient’s ability to understand was under question. This is the job of people like Legion Healthcare Partners to analyze the data and to effectively communicate it.

The next step is in January 2021 when it is proposed that private payor negotiated rates will be published. There will be plenty of excuses and blame to go around of why this is a bad idea. At the end of the day, this is accountability through transparency. There are truths that administrators and others in healthcare know, talk about, and are frustrated with. This will put it front and center. This data will expedite value and transparency initiatives.

Part of this initiative will also be the publication of shoppable services. These will be based on Medicare rates as well as private payor rates. They will include gross charges, discounted cash prices (self-pay), de-identified minimum and maximum negotiated charges. There will be penalties for those that fail to comply.

As I meet with administrators and others there is strong resistance to these changes.

It is imperative for everyone to understand, these changes are going to happen if you choose not to view this as an opportunity, you may want to seek a new opportunity - Jordan Johnson

Transparency involves 2 things: engagement and data presentation. Here are some key points.

• It can be simple and very effective
• It does not have to be expensive
• Make it personal
• Connect the dots and how it relates to the patient-value/quality
• Allow for feedback and act on it.

This has implications on:

• Patient quality, value, empowerment, and perception
• Collections
• Staff engagement and satisfaction
• Operational optimization

Investing the time to check out tools and services that can help your organization stay ahead of the game is important.

The team at Legion HP has developed a Radiation Oncology Optimization Suite that will solve all of your financial and operational pain points, including price transparency.