The New Reality of Patient-as-Payer

In theory, health care consumerism is a straight-forward idea: Shifting costs to consumers, typically in the form of high-deductible health plans (HDHPs), gives them an incentive to make informed decisions about the health care services they purchase. In practice, consumerism represents a significant challenge to providers’ bottom lines. A recent report reveals that for 74% of providers, patient collections take over a month. Further, 66% of providers said patient receivables are a primary revenue concern.  Please click on this link to view the entire article. Health Care Consumerism.

COURT RULES THAT HOSPITAL PRICE TRANSPARENCY REQUIREMENTS CAN TAKE EFFECT

The Department of Health and Human Services (“HHS”) received a victory this week in the litigation challenging the agency’s final rule that requires hospitals to publicly disclose the prices they charge, as well as their specific reimbursement rates with third-party payers (“Price Transparency Rule”). The Price Transparency Rule is scheduled to go into effect on  January 1, 2021.The court’s decision comes amid calls from across the industry to delay the Price Transparency Rule’s effective date to allow hospitals, already burdened by COVID-19, more time to prepare for the arduous publication requirements. With the effective date only a few months away, however, this court victory, combined with indications HHS appears committed to the current timeframe, means hospitals must continue preparing to meet the requirements included in the Price Transparency Rule.  For more information please click on this link

Joint Statement: Roadmap for Resuming Elective Surgery after COVID-19 Pandemic

In response to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS), the U.S. Surgeon General and many medical specialties such as the American College of Surgeons and the American Society of Anesthesiologists recommended interim cancelation of elective surgical procedures. Physicians and health care organizations have responded appropriately and canceled non-essential cases across the country. Many patients have had their needed, but not essential, surgeries postponed due to the pandemic. When the first wave of this pandemic is behind us, the pent-up patient demand for surgical and procedural care may be immense, and health care organizations, physicians and nurses must be prepared to meet this demand.  Facility readiness to resume elective surgery will vary by geographic location. Please click on this link for a list of principles and considerations to guide physicians, nurses and local facilities in their resumption of care in operating rooms and all procedural areas.