Clinicians are often uncomfortable talking about the cost of the care they provide, and they probably don’t have the pricing information patients are seeking. Self-paying patients and those insured under high-deductible health plans may be embarrassed to talk about the financial strain of big-ticket services such as heart surgery or even a routine colonoscopy.
Avoiding the cost-of-care conversation is not a good option because negative outcomes could occur, such as patients foregoing needed care, choosing another facility that proactively shares pricing information and financing options, or scheduling their procedure but responding angrily to unexpected bills that leave many in a state of desperation.
To avoid such scenarios, and contend with rising bad debt, growing numbers of hospitals are joining the price transparency movement. They’re equipping dedicated staff with financial scripts that guide them in speaking compassionately and with one voice to patients as they lead them from pre-registration through collections..
All staff who interact with patients should have at least a general understanding of an organization’s pricing policies or know where to direct patient questions on this topic. Staff dedicated to discuss pricing policies should have an intimate knowledge of the organization’s policies and pricing process. Here are a few suggestions to ensure the financial scripts they’re following adequately cover the information patients need.
Tip 1: Put price in context with quality and safety information. Just because savvy healthcare shoppers are looking for low-cost deals doesn’t mean they’re not on a quest for value. You can bet that they’ll care about complications and mortality rates if they’re about to have open-heart surgery. It’s also likely they’ll take note of patient satisfaction ratings readily available online; include these quality and satisfaction ratings in your pricing information when available.
Tip 2: Communicate directly. Avoid big words and cut to the chase. Invite questions from patients, but don’t make them ask about self-pay discounts, their out-of-pocket obligation and other issues they would want to know about. Be ready to answer these questions or describe the process through which the patient can get answers. Keep in mind the link between poor financial literacy and poor healthcare financial behaviors as well.
Tip 3: Be as patient-specific as possible. Payers have long used pricing transparency tools to produce coinsurance and deductible information specific to individuals. Hospitals could do likewise. Price estimates are based at least partially on averages and norms, but personalization can be achieved by communicating in a patient-centered manner. For example, respect individual preferences and socioeconomic conditions, and fully share information in a timely manner so patients and their family members can make informed decisions. The more patients actively participate in shared decision-making as part of the care team, the greater their understanding of their financial responsibilities for that care.
Tip 4: Explain the difference between charge, cost and price. To patients, cost is the out-of-pocket amount they must pay for healthcare services—and, for the uninsured, it’s also the price. The charge is generally irrelevant, since it’s the base against which all payers negotiate.
Tip 5: No surprises. Be sure patients understand that the prices provided are estimates, and that the actual price will depend on their medical situation and if unexpected complications occur. The average price for a procedure or service—which is all some transparency programs currently provide—may in fact be a misleading indicator of true cost differences. Be sure to cover what’s not included in the estimate such as physician and anesthesia fees, so patients know what other bills to expect.
Tip 6: Find out if patients will need help paying for their hospital care prior to providing care. Holding off on financial discussions until after healthcare services are delivered reduces their ability to access Medicaid, charity care or other financial assistance programs and lowers the odds of ever receiving payment.
Tip 7: Seek feedback from patients and their advocates. Don’t wait for a Google Alert about an unflattering patient comment about your payment policies. Regularly convene focus groups or enlist past patients or family members as secret shoppers for an honest assessment of where you’ve fallen short and what you might do differently.