How Providers Gamed the System by Offering Chargemaster Prices Without Insight

How Providers Gamed the System by Offering Chargemaster Prices Without Insight

The Center for Medicare and Medicaid Services (CMS) required hospitals to post their standard charges for every item they use (also known as chargemaster prices) online from the 1st of January. Their expectation was that this price transparency would translate to patient empowerment, as it would enable patients and their caregivers to make informed choices between healthcare providers, based on the cost of the treatment required.

In full compliance of the regulatory requirements, hospitals around the US have made their chargemaster price information publicly accessible. The providers, however, have failed to give meaningful access to the costs related to patients and their treatment. Let’s delve deeper and understand why unloading data related to cost of treatment without any insight is not helpful:

  • Hospitals dumped all the costs in huge lists online without throwing light on the cost of specific services. So, if someone wanted to compare the costs involved in a tonsillectomy, not only would they need to know the names of each consumable, each test, and each service but also the doctor/specialist charges that would be incurred during such a surgery.
  • Some providers have posted a link to an excel sheet online, which displays massive columnized lists showing prices of more than 20,000-35000 items, making it difficult if not impossible, to verify the costs prior to availing any medical service.
  • Many of these lists posted online use abbreviated names, codes, and mixed-up terminology, making it nearly impossible to understand anything from them.
  • Thousands of services have been listed with minor variations and described using abbreviations and codes to reflect price variations. This makes the process even more cryptic.
  • Some providers have displayed the costs using complex software which is only machine readable and defeats the purpose of a transparent policy.

chargemaster prices

The raw data that’s been dumped online is useless to the public and could even be misleading. But of course, there are always exceptions to any rule and some consumer-friendly hospitals like El Camino Hospital in Mountain View, Calif., Baylor Scott & White, Tx., among others. They have invested the time and effort needed to provide transparent online tools which enable patients to make a reliable estimate of the out-of-pocket expenses they would incur for their services. These tools factor in an individual consumer’s health plan benefits and deductible status before providing the estimate.

Currently there are no checks in place to ascertain the integrity of the data posted by providers online and no penalties for non-compliance. Therefore, it is necessary for the CMS guideline to include some checks and balances to attain true price transparency. Till then, the patients and their families will have to contend with complex documents to analyze cost differences across different care options.

5 Innovative Ways Microsoft Teams is Transforming Care Coordination

5 Innovative Ways Microsoft Teams is Transforming Care Coordination

Healthcare in 2019 is all about value of care. While healthcare payors and providers have been heavily investing in the latest medical technology, productivity tools have somehow remained outdated. With renewed focus on value of care and clinicians increasingly resorting to innovative and complex treatment paths, care delivery is becoming more collaborative and team-based. It is therefore imminent that healthcare providers invest in tools to empower clinicians for better care delivery using a secure platform.

Microsoft Teams provides a set of care-coordination solutions to enhance patient care, reduce costs and help stakeholders collaborate without risking patient-data privacy and security. Microsoft Teams has slowly established itself as the go-to productivity tool when it comes to patient care. Today, it is preventing thousands of healthcare workers from burnout due to administrative paperwork. While the platform is finding mass-adoption, here are five incredibly innovative ways in which Microsoft is transforming care coordination through Teams:

Aggregate patient’s records in a secure location

Clinicians can now aggregate all patient data including patient history, lab results, notes on patient health, and previous care results at a single location. Verified team members can access these files related to patient data on a dedicated channel and provide inputs as the patient traverses through the care continuum. A centralized care plan not only reduces time to value-care for patients but also reduces hurdles for clinicians by providing a safe collaborative environment.

Meet and make decisions even if offsite

Microsoft Teams makes decision-making simpler and faster. Clinicians can now meet online without the need to be physically present at one location to make decisions on a patient’s case. Every member on a channel can connect online, even if offsite, and help deliver accurate and faster care for critical cases that require immediate decision making.

Review and update patient care plan records collectively

Now team members can edit and provide updates on patient records through focused discussions within the purview of care delivery plans. Team members can work on Office 365 apps such as MS Word at the same time and review care delivery path in real time.

Integrate EHRs and deliver interdisciplinary care

Health providers are increasingly using integration capabilities of Microsoft Teams to connect to Electronic Health Records and provide a real time communication platform for everyone involved in the patient’s care.

No data privacy risk: HIPAA compliant

Data privacy and security is one of the biggest concerns in the health IT space and Microsoft Teams does a good job of addressing those concerns. The platform is HIPAA compliant with almost 1100 internal controls for data privacy. Microsoft also claims that the ‘platform leverages billions of data signals with machine learning’ to ensure protection of sensitive health data. With such robust tools and features, Microsoft Teams is leading the pack in data security and privacy as a trusted cloud platform.
Aurora network, a not-for-profit healthcare network in the United States is leveraging Teams solution to deliver patient centered care.

By accommodating interdisciplinary decision makers under a single umbrella, Microsoft Teams is helping streamline communication and workflows for better care delivery networks.

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J.P. Morgan Healthcare Conference Set to Attract 9,000 Attendees in Annual Gathering

J.P. Morgan Healthcare Conference Set to Attract 9,000 Attendees in Annual Gathering

The J.P. Morgan Healthcare Conference kicked off on Monday in San Francisco. The conference is the biggest annual healthcare event in the world and rightly so, as more than 9,000 attendees are expected to take part in the conference this year. It is holy ground for healthcare companies looking to present and drive change in the healthcare space. This year, more than 450 companies from biotech, pharma, insurance and hospital systems are participating and presenting.

The conference has come a long way from 1983 when its first edition was hosted. At that time only 20 companies had attended the conference with just 200 attendees. Today, however, the J.P. Morgan Healthcare Conference helps shape and drive issues of importance for healthcare companies for the year.
From healthcare service providers to pharmaceutical firms, the conference is a playfield for everything related to healthcare.

jp morgan healthcare conference area

This year, Health IT is expected to make big news at the conference. Companies like Microsoft, Apple, Google and Amazon have recently started to invest heavily in healthcare and especially into health IT and that is expected to drive a lot of interest at the conference.

New entrants from technology sector like Amazon is developing a machine learning tool which mines patient data and puts them in direct competition with traditional Health IT companies like AllScripts and Cerner. Moreover, entry of new digital therapy companies are also expected to impact the current value chain.

All these new entrants working with existing EHR system raises significant interoperability challenges. At the conference Issues like interoperability in healthcare and the need to consolidate multiple data standards are also expected to drive a big audience. Similarly, solutions like managed care are also expected to make headlines at the J.P. Morgan Healthcare Conference as healthcare service providers and payors look to tackle the menace of rising costs.