The vision

During the chaos of the pandemic, price transparency and No Surprises Act (NSA) regulations required health systems to prioritize providing patient estimates in consumer-friendly ways and implementing new technologies and processes. Leaders at Columbus Regional Health in Indiana saw compliance as more than avoiding fines. Here was an opportunity to make financial transparency a strategic initiative, improving collections and consumer engagement.

Columbus Regional Logo
Key requirements of a compliant price transparency program:
  • Price estimate tool available for patients and guest shoppers
  • Compliant machine-readable file of service prices
  • Proactive delivery of self-pay cost estimates prior to service
  • No Surprises Act disclosures
  • Dispute resolution process

Co-creating the solution

Columbus Regional Health partnered with Chartis on a comprehensive workplan to update its manual process for providing price estimates, ensuring compliance by the 2021 and 2022 deadlines. This included implementing Epic’s Price Estimate tool and NSA workflows, process definition, job description updates, marketing collateral, training, and a communication plan inclusive of clinical departments and patients. Chartis provided IT advisory and build support, applying leading-practice principles to deploy a robust and compliant technical solution. 

Chartis also informed the health system’s comprehensive plan to turn these compliance efforts into a strategic advantage. This plan increased automation and operational change to manage the increased workload without adding to workforce needs. Over a multiyear initiative, Columbus Regional Health was able to go live with all the requirements on time, passing all audits, and even receiving a perfect score from the Employers Forum of Indiana in its evaluation of Indiana hospitals. The work has helped further shift the health system leaders’ thinking about the patient financial experience.

Transformation in action

  • Assess
    Evaluate current state against regulatory requirements

  • Design
    Develop efficient, streamlined processes inclusive of workforce and technology

  • Message
    Craft consistent internal and external messaging to support change management and adoption

  • Automate
    Push the bounds of automation and fully optimize related technology features (i.e., real-time eligibility)

  • Measure
    Track key performance metrics (such as estimate accuracy) to support continuous improvement

Believe in better

By focusing on financial transparency as a strategic initiative, Columbus Regional Health accurately scaled from an estimated 400 price estimates to more than 6,000 estimates delivered monthly to patients. More than 90% of estimates are now provided to patients without manual intervention, and no additional staff are needed. The health system improved insurance and benefit accuracy, implemented electronic signatures, streamlined patient discounting, and increased point-of-service collections. Patients now can easily access cost information for their services through proactive estimate delivery, intuitive website design, and shopper estimates.

Meaningful outcomes

Results from the first year of scaling:

1,259 %

increase in delivered price estimates

$1.03 M

in patient collections through the estimates workflow

0

additional staff required

Partnering with Chartis gave us the ability to not only meet the requirements of the No Surprises Act but also create collaboration between revenue cycle, clinical departments, and information systems to  achieve our strategic initiative of financial transparency

— Heather Hubbard, RHIA, CRCR, Vice President–Revenue Cycle, Columbus Regional Health

Building to better

Organizations can implement a leading-practice patient financial transparency program by:
  • Leveraging regulatory pressures to justify investment in a robust program.

  • Proactively planning for the change this presents to the organization,  both internally and to patients.

  • Aligning processes with automation capabilities to maximize return on investment.

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