We’re excited to announce the launch of the new pricing transparency readiness software and consulting services from Panacea. This software and service will help your health system prepare for and comply with the recently expanded Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule requirements that will go into effect on January 1, 2021.
With these new requirements, your health system must make accessible all negotiated managed care rates in a machine-readable format plus a list of 300 “shoppable” items—non-urgent, high-volume items and services—on your website or via an interactive tool for consumers. Health Systems are expected by CMS to develop a unique shoppable list for each provider with their system. The intent is to provide an easy way for consumers to determine, in advance, the allowed payment for their prospective service based on their insurance or if with an interactive tool their patient pay obligation.
Meeting this requirement will require a significant effort for most health systems, which is why Panacea has developed software tools and consulting services.
How we can help?
We are making the process of complying with the CMS requirements easier with options to choose from:
- Shoppable Disaggregation Algorithm and Report Set
- Machine Readable File
- Consumer Display Options
- Static display to meet minimum requirements (expedient and economical)
- Interactive display where patient can enter deductible and co-pay information to obtain estimated out-of-pocket expense
- Interactive display integrated with eligibility system to estimate out-of-pocket expense
- Hospital Zero-Base Pricing system to restructure and develop rational pricing with a focus on your shoppable list
Please Note: We urge you not to have a false sense of security due to the court actions taken by the industry. Use this time wisely to prepare for the January 1, 2021 effective date. Even if aspects of the final rule related to the requirement to publish all negotiated rates are overturned, it is likely that these other requirements will remain, even if they are modified to only be accessible to consumers solely for their own insurance. Additionally, consider that providing average charge and payment information for 300 shoppable items and services even if simply displayed between in-network and out-of-network insurance types will be well received by consumers.