Chief Medical Quality Officer at University of Utah Health Sciences CenterConnection Pending
Administrative Director at University of Utah Health Hospitals and ClinicsConnection Pending
Director - Interactive Marketing and Web at University of Utah Hospitals and ClinicsConnection Pending
Professor of Radiology Associate, Chief Quality Officer, University of Utah HealthConnection Pending
Rising healthcare costs and cost shifting from employers to patients have created an increasing financial burden for patients. University of Utah Health conducted online value surveys to 5031 patients, 687 physicians, and 538 employers and asked their perspectives of value of care. Respondents were given an opportunity to choose “value statements” from an extended list. In the macro view, patients and physicians were aligned in that quality of care was the most important aspect when receiving or delivering care. When broken down to specific value statements, the top value statement selected by patients was “affordable out-of-pocket costs” (45%) (Figure). Notably, the number was higher than “my health improves”(32%). The results highlight the importance of out-of-pocket costs of care to patients. The Utah Value survey was featured on Harvard Business review last February.
When we purchase goods and services, we expect the information about quality and price to be readily available in order to make an informed decision. We also read online reviews and customer experiences before making any purchase decisions. This simple ritual does not work for healthcare. Facing severe medical illness or unexpected injury, patients may not feel comfortable asking their doctors how much they have to pay to receive the care.
University of Utah Health Price Transparency Tool
Among the three types of costs (charges, payments, and patient costs), patient costs (out-of-pocket expense) is the most difficult one to estimate. Out-of-pocket expenses depend on the insurance type, amount of unmet deductible, applicable co-pay, and availability of co-insurance. University of Utah Health is the first system in the Mountain West and one of the few in the country to provide the interactive online price estimate tool for our patients to assist their decision making. healthcare.utah.edu/bill/#pric...
This new price transparency tool allows patients to obtain an estimate of a patient's out-of-pocket expense for the care they are going to receive. The tool lists procedures and tests ranging from ankle fractures, vaginal delivery, cataract surgery to a CT scan of the abdomen with contrast. The tool asks patients a series of questions regarding their type of insurance, the amount of unmet deductible, and co-insurance, etc. The estimates for commercial insurance are based on the historical average allowable by various commercial payers. We state the disclaimer that the price provided in this tool remains “estimate” and not a contractual agreement by any means.
Full Care Pricing – single medical bill
The University of Utah is one of the few healthcare systems that provide patients with a single bill, called Full Care Pricing, to avoid multiple invoices from the hospitals, clinics, and various providers. The estimated price on the online tool includes both facility and professional costs, as well as prescription drugs and anesthesia. Patients do not need to get the estimate from numerous services separately.
It is critical to provide transparency, not only in price but also quality and patient experience. University of Utah Health was the first system to publish patient experience data on our public facing website.
Price transparency tool viewings
Since the online tool launched in September of 2016, there have been 17,572 pageviews and 8274 total sessions. The average time spent on the pricing page was 50 sec and that on the calculate page was 2 min and 30 sec.
A few examples of patients feedbacks related to the price transparency tool include;
· Appreciated the ability to determine out-of-pocket expense, not just total charges
· Loved that the tool provides a total cost of care – not only the hospital costs
· Easy to navigate and understand
We are in the great collaborative discussion with our patient advisory group about future state enhancements.
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