Ambulatory Pricing: Transform Your Pricing Strategy to Protect and Grow Market Share

October 8, 2018

// By Craig Allan Ahrens and Sarah Hull //

Craig Allan Ahrens, managing director at Ankura Consulting

Craig Allan Ahrens, managing director at Ankura Consulting

Hospital systems will be required to publish their chargemaster “list pricing” online by January 1, 2019, with the finalization of the Fiscal Year 2019 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule (CMS-1694-F).

Many states have made efforts to increase price transparency, but this is the first nationwide mandate. Critics of this requirement have stated:

  1. Publishing charges will create confusion and misunderstanding on the part of patients since it is not the “real” price.
  2. Sarah Hull, senior director at Ankura Consulting

    Sarah Hull, senior director at Ankura Consulting

    Patients will choose to forgo care due to concerns about what it will cost.

  3. Charge transparency will enable payers, employers, the media, and other stakeholders to use the information against health care systems.

A litany of other concerns could be added to the list, but few health care leaders are talking about the opportunities to leverage price as a way to capture patients.

Senior health care leaders should be facilitating conversations to address basic pricing questions:

  1. How we are going to position our pricing versus our competitors?
  2. How will the charge price transparency mandate impact the market’s perception, and how will it impact our patients and mission?
  3. Do we have a plan that aligns the infrastructure, processes, and communication tools, and prepares our organization for the mandate?

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