Providers, health plans and patients alike rarely know how much money any given care will cost each stakeholder, a problem that stifles competition and drives up costs, experts say. The antidote is price transparency, a cause that got a big boost this week when the Healthcare Financial Management Association (HFMA) announced the creation of a task force to improve transparency in healthcare transactions.
 
The HFMA task force will include both healthcare and consumer groups, and the move comes shortly after CMS caused a stir by releasing hospital charge data, which revealed dramatic variations in what hospitals charge for the top 100 most commonly billed hospital procedures.
 
The charged amount is virtually never the amount actually paid and received, but the data still led to a public outcry against high charge amounts. Patients are often caught off guard by costs, particularly out-of-network fees when they thought they were in network. Providers have also been hurt by a lack of transparency, as highlighted by the 2009 class action lawsuit filed by physicians and the American Medical Association against UnitedHealthcare for systematically underpaying out-of-network services using a biased database of local fair market charges.
 
Tools to help: Providers have historically set their charges and negotiated their contracts without consulting any kind of charge data. Fortunately, tools now exist to level the playing field. Check out this free webinar demonstrating FeeCalc, a charge-setting workflow tool that puts Medicare fees and commercial charges for CPT© and HCPCS codes at your fingertips in seconds. Sign up now for this free July 17 webinar.