In America, healthcare is unlike every other aspect of the consumer experience. For example, you wouldn’t leave your car with a mechanic before getting an estimate. But many people receive care and treatment without any idea of the costs — until the bills start to roll in.
The traditional relationship of “doctor knows best” has created a system where many patients may be left in the dark surrounding the scope of their treatment. Enter Power to the Patients: an awareness campaign to combat the hidden prices of healthcare. Learn more about Power to the Patients, price transparency, and what’s being done to help consumers make cost-conscious decisions.
What Is Power to the Patients?
Power to the Patients is an awareness campaign to combat healthcare’s hidden prices. The campaign strives to raise awareness that price transparency is a patient’s right before receiving care.
Who is involved in Power to the Patients?
Activist and Academy-Award winning actress Susan Sarandon, activist and artist Shepard Fairey, and Grammy, Emmy, and Tony Award-winning actress Cynthia Erivo serve as ambassadors for the campaign. Additional ambassadors for the campaign include Boston Marathon bombing survivor Adrianne Haslet, photographer Martin Schoeller, and artists Tats Cru, ARTXIV, JEKS ONE, and Pamela Bliss.
The Power to the Patients Mural Project
According to PR Newswire, Power to the Patients has started a mural project across the U.S. featuring art created by Shepard Fairey. Public murals have been completed in cities across the country including Nashville, New York, Los Angeles, Seattle, Detroit, and more, with additional murals slated to begin nationwide including Portland, Dallas, and Denver.
What Is Price Transparency and the Healthcare Revolution?
Price transparency helps North Americans know what a hospital charges for their services and items they receive.
Per the Centers for Medicare & Medicaid Services (CMS), hospitals have been required to provide clear pricing information online as of January 1, 2021 in two ways:
- A machine-readable file including the standard charges for all items and services provided by the hospital: gross charges, discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges.
- A consumer-friendly display of shoppable services including 300 “shoppable services” (or as many as the hospital provides) that a consumer can schedule ahead. This should include service descriptions, discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges.
However, this is not always the case. Additionally, prices still widely vary — even within the same hospital, depending on what each insurance plan has negotiated with that hospital.
Who enforces price transparency for hospitals?
CMS helps consumers have the information they need from hospitals to make fully-informed decisions regarding their healthcare. In addition to audits, CMS also investigates complaints and reviews analyses of non-compliance. As a result, hospitals may face civil monetary penalties.
What happens if a hospital doesn’t comply?
CMS is proposing to set a minimum civil monetary penalty of $300 each day for smaller hospitals with a bed count of 30 or fewer. Hospitals with a bed count greater than 30 would be penalized $10 per bed each day, not to exceed a maximum daily amount of $5,500. Under this proposal, the minimum total penalty amount would be $109,500 per hospital, with the maximum total penalty amount reaching $2,007,500 per hospital.
Pros and Cons of Price Transparency For Hospitals
The benefits and drawbacks of price transparency for hospitals are similar to the pros and cons in other business settings. Transparency builds trust and sets expectations, but it also means that some patients may be more inclined to shop around before receiving the care they need.
Pros of hospital price transparency
Thanks to high-deductible health plans, patients are now responsible for a larger portion of their bills. Setting clear expectations, along with clear communications and easy-to-use payment options help them prepare and feel in control of their own care.
It’s also important for hospitals to keep in mind that price transparency is now part of the patient experience. Nurturing or neglecting these issues could impact reimbursement and patient relationships.
Cons of hospital price transparency
As mentioned above, one disadvantage to price transparency for hospitals is that patients could take their quotes and shop around for care. Some have also predicted that price transparency could drive down the overall cost of healthcare.
Additionally, billing transparency isn’t always easy to put into practice. For example, when patients change plans during open enrollment, changes to their out-of-pocket responsibilities aren’t always clear. It’s not always as simple as posting or quoting a price, but price estimation tools can also help manage expectations.
Healthcare Revolution FAQs
What is Power to the Patients?
Power to the Patients is an awareness campaign to combat the hidden prices of healthcare.
What are some patient’s rights?
According to the American Medical Association’s Code of Medical Ethics Opinion 1.1.3, every patient has the right to courtesy, respect, dignity, and timely attention. They also have the right to receive information and the opportunity to discuss the benefits, risks, and costs of appropriate treatment alternatives, including forgoing treatment.
Why is price transparency important in healthcare?
Healthcare is becoming increasingly expensive and making decisions surrounding care can have life-long physical and financial consequences. Price transparency is vital to making patients feel prepared and informed.
What are the benefits of clear pricing in healthcare?
Clear pricing in healthcare helps set clear expectations between patient and practitioner. It’s important for hospitals to follow new transparency rules to remain compliant, receive proper reimbursements, and maintain good patient relationships.
Power to the Patients Conclusion
Patients have a legal right to know a hospital’s prices before they receive care. Now they must step up and exercise this right by demanding price transparency as a condition of service.
Before making your healthcare appointments, check the provider’s website for pricing or ask them to provide it. By coming together to demand quality care at clear prices, consumers can enjoy substantial healthcare savings in the future. Additionally, take the time to get health insurance quotes to ensure you’re properly covered.