An Open Letter from the CFO to Our Patients:
For over 25 years I have been working in healthcare finance and have seen tremendous change in the industry. Much progress has been made in improving the health of our nation through innovation and research. Unfortunately, these improvements have come at a cost to us all. The result that we are all looking for is the ability to provide world class healthcare to our citizens at a price we can all live with.
With the goal of providing pricing transparency to patients and payers, CMS has placed a requirement on all hospitals to post their charge master data in a machine readable format. While I applaud CMS for working towards helping all to understand the cost of healthcare and finding ways to control those costs, it is my belief that this step will not truly help our patients to understand the cost to them for their care.
For many of our citizens, there is a triangle of parties involved in the healthcare payment process. First and foremost is YOU, our VIP Patients who come to us for care. Many of you have some sort of insurance coverage, whether it be Medicare, Medicaid, Blue Cross or some other payer helping you to cover the costs of your care. The triangle created between us as the provider of care, you the receiver of care, and your insurance coverage (if available) can further muddy the waters of understanding what the true cost of care is.
The charge master, for any healthcare system, is only a starting point on the journey for determining what the true cost of care is for the patient. This is because every healthcare organization has contractual agreements with various payers, and not all agreements pay the same amount. Not only that, but to further complicate the issue, each patient’s policy with their insurer will involve different levels of deductibles, co-payments, and co-insurance levels based on what their company’s plan is with the payer. It can be very complicated to understand the payment structure that is created by this triangle of contracts and relationships. To further add to the challenge, every patient is unique even in instances where the same procedure is performed.
Because of all of the moving parts I wanted to take pricing transparency one step further than CMS’s requirement. You will find on this page a link to our charge master for your review; however, you will also find the option to send us a message to get a personalized quote for your procedure. This will allow us to give you an estimate of what your total charges might look like in addition to reviewing your insurance policy allowances so that we can give you a much clearer picture of what you would ultimately owe out-of-pocket. If you do not have health insurance coverage, we can certainly provide the same information for you, which will help you to plan for your financial obligations.
Our patients come first in all that we strive to accomplish. I welcome your feedback as we continue on this journey together with the ultimate goal of pricing transparency.
Chief Financial Officer
Jack Hughston Memorial Hospital