The wave of price transparency is here, with regulations like the No Surprises Act and the Hospital Price Transparency Rules building momentum. Jen & Mindy are joined by Vynamic’s Keith Sutter and Head of Health Plans, Saurabh Raman, to discuss what these laws mean for payers, providers, and ultimately, consumers. The push towards transparency can be traced back over the last decade, but the recently implemented No Surprises Act (01:44) and Hospital Price Transparency Rules (02:13) are directly aimed at helping consumers understand true healthcare costs and make informed care decisions (03:30). Implementation is not without its challenges – with providers citing reporting burdens, administrative costs, and difficulties in accurately reflecting the costs of individual “care episodes” (07:28). With a summer deadline approaching, soon payers (10:00) will be dealing with pace pressures, the disconnect between posted prices vs. true cost, and how to capture quality vs. price (11:13). Despite these challenges, there are opportunities for provider and payer organizations associated with these changes (13:47) – especially for organizations experienced in value-based care and those prepared to leverage price transparency to improve customer satisfaction (18:08).

For additional information, check out Vynamic’s recent insight “Transparency in Coverage Is Here”.

Podcast Tags: healthcare, providers, health plans, price, surprise bills, transparency, value based care

Source Links:

· https://vynamic.com/insights/transparency-in-coverage-is-here/

· https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills#:~:text=The%20No%20Surprises%20Act%20protects,network%20air%20ambulance%20service%20providers.

· https://www.healthsystemtracker.org/brief/price-transparency-and-variation-in-u-s-health-services/

· https://www.commonwealthfund.org/publications/newsletter-article/health-care-price-transparency-can-it-promote-high-value-care

· https://jamanetwork.com/journals/jama/fullarticle/2778818

· https://healthpayerintelligence.com/news/what-the-healthcare-price-transparency-order-means-for-payers

· https://www.federalregister.gov/documents/2020/11/12/2020-24591/transparency-in-coverage#h-11

· https://revcycleintelligence.com/news/only-14-of-hospitals-met-price-transparency-rule-compliance

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC.

Saurabh Raman, Director and Head of Health Plans Sector

Saurabh.raman@vynamic.com

Keith Sutter, Director

keith.sutter@vynamic.com

Mindy McGrath, Executive and Healthcare Industry Advisor

Mindy.mcgrath@vynamic.com

Jen Burke, Director and Healthcare Industry Strategist

jen.burke@vynamic.com