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Since their introduction in January 2021, healthcare providers have largely overlooked the Centers for Medicare and Medicaid Services (CMS) price transparency regulations.
However, with CMS now imposing substantial fines for non-compliance, rural hospitals stand to gain from competitive pricing and enhanced digital engagement.
Healthcare providers are required to compile and publicly display extensive billing data, including a machine-readable file of all standard charges and a consumer-friendly list of 300 shoppable services.
Shoppable services refer to non-emergency care where prices can vary among providers. For example, a patient requiring an MRI could compare costs for this procedure at different facilities in their region based on their insurance coverage.
A recent JAMA study found that about 51% of hospitals do not comply with CMS requirements.
Healthcare providers have been slow to comply with CMS price transparency rules because it is a complex and demanding process. Facilities must gather and update a wide range of information annually for each chargeable item, including gross charges, contracted prices with each payer, a discounted cash price, and the minimum and maximum negotiated prices.
Compliance also carries financial risks, such as revealing competitive disadvantages.
The healthcare sector's recovery from the pandemic has also influenced CMS's initial hesitation to enforce the penalty of $300 per day against non-compliant hospitals.
Recently, CMS imposed significant fines on two Georgia healthcare providers, Northside Hospital Cherokee and Northside Hospital Atlanta, totaling over $1 million. This action indicates a more assertive approach to enforcement.
Going forward, CMS will audit hospital websites and review public complaints to assess compliance. Non-compliant providers will receive a warning, a request for corrective action, and potentially a civil monetary penalty, which will be publicized.
This development is an alert for larger providers lagging in compliance, but it offers an opportunity for rural hospitals to improve their market position.
Rural healthcare providers frequently offer lower prices than urban hospitals, rendering them more appealing to cost-conscious patients.
An increased customer base can significantly benefit remote hospitals struggling financially. Adopting price estimation and contract management technologies can provide accurate financial expectations for patients and ensure correct payer reimbursements.
Providing online price estimates can increase customer satisfaction. A comprehensive digital patient experience includes eStatements, online bill payment, and digital support, as well.
MEDHOST offers a solution to help hospitals display accurate, current pricing and leverage digital tools for improved patient care and revenue.
This includes a web-based search page for the 300 shoppable services, automatic generation of comprehensive, standard charges, integration with contract management tools, and minimal disruption to existing customer workflows.
For more information, reach out to us at inquiries@medhost.com or call 1.800.383.6278.
For over 35 years, we’ve had the privilege of witnessing the unparalleled compassion, commitment, and self-sacrifice of the healthcare workers who staff this nation’s rural hospitals.
Along with an impressive collection of reviews for diners, photos with roadside attractions, and souvenirs from small-town claims to fame, we’ve also managed to garner a number of insights from providers and organizations invested in improving the health of their communities. We’ve used those insights to craft affordable, customizable solutions that meet these facilities where they are and tackle their unique needs.
In this blog, we’ll unpack how our latest solution—MEDHOST Rural Emergency Hospitals (REH) Package—is addressing the issue of financial viability and healthcare access for rural populations.
The partnerships we’ve made among rural providers have given us a front-row seat to the decline of rural healthcare access. Clinics and hospitals in these areas have long been struggling with a host of financial stressors, but the pandemic dramatically worsened this situation. While providers shut the doors, people have begun to ask what will become of these communities and their economies.
To tackle the issue, congress recently passed legislation allowing certain hospitals to bring in more revenue, or reopen, as Rural Emergency Hospitals (REH), providing critical care and services to these remote patient populations.
When we saw this coming down the pipeline, we didn’t waste any time crafting a solution that could help our partners take full advantage of its benefits. We’ve already helped hospitals to adopt this designation, and we want others who may be struggling financially to know that a lifeline is available.
The Rural Emergency Hospital (REH) was established under the Consolidated Appropriations Act of 2021 to address the healthcare disparities and accessibility issues faced by rural communities. This new Medicare provider type aims to provide an opportunity for community hospitals that are struggling to bring in enough revenue, especially those competing for financially desirable patients with larger short-term acute care facilities.
Hospitals that convert will receive a 5 percent increase in Medicare payments for outpatient services and an average annual facility fee payment of about $3 million. This additional payment will also increase each year by the same percentage as the hospital market basket increase.
Considering that 66 percent of Medicare payments to small and rural hospitals are coming from outpatient and emergency services, this is a potential game changer for struggling facilities.
Providers who meet all three of the following criteria may be eligible:
Backed by over 35 years of serving rural and community healthcare providers, our REH conversion solution includes practical strategies and tools to strengthen America’s rural healthcare providers and ensure long-term success.
Here’s what you get:
Don't let financial challenges jeopardize the health of your community. Contact us today at 1.800.383.6278 or email inquiries@medhost.com to learn more about our Rural Emergency Hospital Package.
