A hospital is a place with many moving parts – an ecosystem with countless procedures, treatments, medications, and staff interconnected to provide vital patient care.
The complexity of patient care often creates a financial burden on the hospital when unnecessary expenses remain hidden, and the true cost of care remains unknown. Just one indication of how complex the US healthcare system is.
On top of this, the American Hospital Association reports that Medicare paid just 82 cents for every dollar hospitals spent caring for Medicare patients. This resulted in a shortfall of almost $100 billion in 2022. Continuous financial pressure from the shortfall of payments affects the functioning of hospitals and health systems.
Tracking and managing expenses is a challenge that needs to be addressed to make up for the shortfall and make healthcare financially viable for hospitals. With healthcare price transparency tools, you can dissect the care costs for a particular patient against industry benchmarks to find areas for improvement.
This blog will discuss how healthcare cost transparency tools work. We’ll also talk about the top tools currently available in the market and help you choose one that would enhance your workflows, reduce care variation, and lower costs.
The Growing Importance of Cost Transparency in Healthcare
The hospital price transparency rule enforces the mandate of Section 2718[e] of the Public Health Service Act. It says that every hospital in the US should create and disclose an annual list of standard rates for the goods and services they offer. They are also required to refresh the list regularly.
To comply with the regulations and assess the financial viability of your hospital, finance teams must prepare the cost sheet. With comprehensive cost data, you can also identify areas of inefficiency and make operations more efficient for better margins. This way, you can allocate resources better and adjust your pricing strategies accordingly while lowering costs. This helps you remain competitive in the long run.
What are Healthcare Cost Transparency Tools?
Healthcare cost transparency tools help healthcare providers understand their financial operations in a clear and comprehensive manner. They integrate with your EHR system to collect and organize relevant information related to the cost involved.
These tools can analyze the data on length of stay, imaging, labs, medications, procedures, and more to provide relevant, meaningful insights.
As physicians access cost and care utilization insights, they can make better decisions for any particular patient to bring down overall costs while providing the best care possible.
Note: Some cost transparency tools may not provide in-depth details or be EHR-integrated. They may provide cost details for different hospitals for comparison purposes.
Top Healthcare Cost Transparency Tools
Here’s a comprehensive overview of the top four healthcare cost transparency tools currently available in the market:
1. CareGauge
EvidenceCare’s CareGauge is one of the best healthcare cost transparency tools that provide physicians access to timely and relevant information for the best possible care. It integrates seamlessly into the physician’s existing EHR workflow.
Physicians can compare the care decisions of any particular patient against that hospital’s benchmark treatment data. They can use this comparison data to reduce avoidable variance and low-value care.
Key Features
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- Seamless EHR integration: CareGauge integrates with leading EHR systems, such as Epic, Oracle Cerner, and MEDITECH, to provide a smooth and non-disruptive user experience. This minimizes the learning curve for physicians and maximizes adoption rates.
- Instant insights: CareGauge directly provides real-time cost and utilization data within the EHR. It helps the physicians make informed decisions without disrupting their workflow. This results in reduced length of stay and fewer unnecessary tests and procedures.
- Compare against benchmark data: Physicians can use CareGauge to compare a patient’s care patterns against locally benchmarked patients with similar conditions (by DRG codes). It helps them identify potential areas of overutilization or underutilization. This data-driven approach encourages evidence-based practice and reduces low-value care.
- Real-time cost comparison: CareGauge provides real-time visibility into the cost implications of the decisions made by physicians but still gives physicians the ultimate control over care decisions. Thus, they can manage costs without compromising the quality of care.
2. Healthcare Bluebook
Healthcare Bluebook is a prominent player in healthcare price transparency tools. It digs the data related to health care services, such as imaging, elective surgeries, and more. Patients can leverage this tool to compare costs for various procedures and services across different providers in their area.
Based on the data, you can understand how well your hospital is doing in terms of patient care costs and try to adjust your pricing strategy accordingly.
Key Features
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- Compare prices: Healthcare Bluebook allows patients to compare prices for various procedures across different providers in their area.
- Fair price™ identification: The tool helps compare common medical services and procedures in the area. You can use it to identify your prices against other providers offering good value for their money.
- Quality information: While not comprehensive, the tool provides some quality information for common inpatient procedures.
- Mobile accessibility: The tool is available as a web and mobile application. It provides convenient access for patients on the go.
3. Turquoise Health
Turquoise Health is another platform that helps healthcare providers with information about hospital, payer, professional, drug, and device rates. With access to a vast database of pricing information, Turquoise Health enables providers to benchmark their rates, negotiate contracts more effectively, and ultimately enhance their competitive position in the market.
Key Features
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- Clear rates data: Get access to pricing information with access to records of hospital, payer, professional, drug, and device rates. Understand the market deeply and make informed decisions about your pricing strategy.
- Custom rates: Get laser-focused insights with the ability to view, filter, and benchmark a customized slice of payer data.
- Compliance+: Stay ahead of the regulatory curve with a comprehensive suite of tools that ensure full compliance with CMS price transparency requirements, including Machine-readable Files (MRF) creation and patient estimate tools.
- Search functionality: Explore any market, service code, or payer/plan. While this capability is undoubtedly valuable, some users may find the interface slightly less intuitive than other tools.
4. Clarify Health
Clarify Health distinguishes itself as one of the sophisticated healthcare price transparency tools. It is useful to compare health plans and providers for value-based care. Its platform tackles the challenge of making sense of vast amounts of healthcare pricing data. It provides insights at the individual payer, provider, DRG, and CPT code levels.
Key Features
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- No-code query engine: Clarify allows users to access and analyze price transparency data without the need for complex coding or technical expertise.
- Rate intelligence: The platform provides in-depth analysis of rate data at various levels. This granular view enables users to identify cost variations, benchmark performance, and pinpoint opportunities for savings.
- Network optimization: Clarify combines rate intelligence with provider quality performance insights to access performance as a provider.
- Contract negotiation: With rate data and market insights, you can approach contract negotiations with greater confidence.
How to Choose the Right Cost Transparency Tool for Your Hospital
The ideal cost transparency tool will help you get the best return for your investment. Besides, choosing the right tool depends on how you will use it. Here are some specific things that will help you make an informed decision:
1. Access needs
Begin by clearly defining your cost transparency objectives. Some questions you may want to answer include:
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- Do you want to identify and eliminate waste in your processes?
- Do you need help understanding the true cost of delivering care across different departments and service lines?
- Would real-time insights into resource utilization help you make more efficient decisions?
- Are you looking for deeper insights into market rates and benchmarks to inform your contracting strategy?
- Do you want to empower patients with upfront cost estimates and promote transparency in your pricing?
Understanding your priorities will help you narrow down the options. It will help you focus on tools that address your specific needs.
2. Key considerations
It’s important to understand what you expect from the tool. The ideal tool should meet your current demands and support your long-term growth. Here are certain factors that would help you out:
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- EHR integration: Your healthcare cost transparency tools should integrate well with your existing EHR system for efficient data collection and analysis.
- Data analytics: You will need to greatly analyze large volumes of data and generate meaningful insights. Choose one that will give strong analytics from which you can extract helpful information.
- Ease of use: An intuitive user interface will let the tool reach maximum adoption, through which it can provide maximum value. Opt for tools with intuitive designs and clear visualizations.
- Scalability: Remember your hospital’s growth plans and select a tool that can scale to meet future demands.
- Cost: Consider the total cost of ownership. It may include the cost of implementation, licensing fees, and ongoing maintenance fees.
3. Get demo
Request demos or trials of the tools that pique your interest. This hands-on experience will help you understand their features, functionalities, and user experience. Engage with the vendor’s representatives, ask questions, and seek relevant testimonials.
As you consider your hospital’s needs, evaluate key factors, and then engage in hands-on trials, you can confidently select the right cost transparency tool to empower your organization and deliver exceptional patient care.
Embrace Healthcare Cost Transparency With CareGauge
With growing financial pressure on hospitals and the requirement for more transparency in hospital pricing by physicians and patients, cost transparency has only taken on greater importance.
Specialized healthcare cost transparency tools bring data-driven insight that will help a hospital optimize operational efficiencies, improve patient satisfaction, reduce treatment costs, and decrease length of stay.
Ready to see how cost transparency can work for you? Schedule a personalized demo with CareGauge.
Our team will show how our real-time, EHR-integrated solution empowers physicians and transforms your hospital’s financial health.
