Growing Market Demand for Solutions to Support Defensible and Transparent Pricing in Face of Changing Market Forces
MedAssets today announced that AHMC Healthcare Inc., and Alhambra Hospital and Medical Center has expanded its relationship with the company in pursuit of a rational and defensible pricing strategy. Plans call for a combination of the company's Patient Access Solutions, Contract and Episode Management Solutions and Charge, Pricing and Compliance Solutions to improve the accuracy of patient bill estimation and gain market intelligence to inform payor contract negotiations.
"As a fully integrated healthcare system, it is important that we remain focused on aligning our pricing strategy across our entire continuum of care," said Linda Marsh, senior executive vice president, AHMC Healthcare Inc., and Alhambra Hospital Medical Center. "Validating that prices not only cover costs, but are also defensible, transparent and competitive, is an ongoing healthcare challenge that promises to only increase as a business priority. The expertise and proprietary data analytics tools from MedAssets promise to deliver insights and best practices to inform our charge and contract decisions, and optimize our net revenue while creating better pricing transparency to the community we serve."
Organizations across the country are improving business capabilities related to patient billing estimation, payor contract modeling and chargemaster management. Over the past 12 months, MedAssets has seen a nearly 30 percent year-over year increase in the number of providers employing the company's proprietary revenue cycle analytics tools, benchmarking data, technology automation and consulting services in pursuit of a rational and defensible pricing strategy.
"Providers are facing increasing pressure to balance revenue optimization with the needs of market participants, from payors to patients, and defensible pricing is key to succeeding with this evolving economic value equation," said Amy Amick, president, Revenue Cycle Management, MedAssets. "The breadth of our revenue cycle management capabilities delivers a 360-degree view of pricing that aggregates costs, volume, peers and payors. Our powerful analysis is then complemented by enabling SaaS-based technologies designed to boost productivity and compliance to assure pricing supports our clients' margin achievement goals while staying within hospital policies."
Tracking Actual Cost, Competition and Contractual Considerations
Pricing of patient services has played a traditional role in the financial performance of any hospital, but continues to be pressured by a number of market forces. Americans are paying a growing proportion of their own healthcare bills, and providers are beginning to compete more on cost, increasing the need to defend pricing of services. Provisions of the Affordable Care Act require hospitals to publish a list of "standard charges" for items and services. At the same time, new payor methods to rein in costs, such as narrow networks, value-based payment models, and comparison tools of provider costs and quality, are further complicating how providers establish contract pricing during payor negotiations.
MedAssets offers the following analytics tools and services to help providers achieve a defensible, yet optimal pricing strategy across the revenue cycle:
- CarePricer - Web-based payment estimating technology to increase up-front cash collections, improve patient satisfaction and reduce self-pay bad debt
- Chargemaster Management - proprietary data to benchmark 100 percent of charges and perform comparative pricing
- Comparative Rate Modeling - pricing consulting with a strategic review to improve bottom line and increase the defensibility of charges by taking into account comparative market pricing and payor reimbursement mix
- Contract Modeling - helps providers negotiate more favorable contracts, identify payor trends and more accurately forecast revenue
- Defensible Price Modeling - pricing consulting that examines the relationship of charges to supply and pharmacy costs and reviews the impact of price changes on net revenue
The company is hosting a webinar through HFMA on Thursday, Oct. 9 from 2:00-3:00 p.m. CDT, for providers interested in learning how to create and maintain a defensible pricing strategy. MedAssets Vice President of Revenue Cycle Advisory Solutions, William Davis, will share the key elements to consider when evaluating a strategic pricing approach, and will discuss best practices for connecting pricing transparency to various programs, including patient access, charge capture, physician preference items and more.