Health care pricing transparency

In an era of rising health care costs and consumer-driven financing alternatives, the need for health care cost transparency solutions has become increasingly important. Consumers demand information about their health care fees, and regulatory measures will continue to drive this need. In order to stay competitive, as well as responsive to market and patient needs, health care organizations like yours should embrace this movement and launch a comprehensive pricing transparency strategy. The cornerstones of this strategic effort include weighing procedure costs, managed care and market risk. The professionals at RSM are poised to help you through all phases of this strategic implementation.

Our approach
Our consultants begin by working with you to establish a rational pricing methodology by rebasing charges for items and services within your organization. Next steps include: 

• Evaluating the range and relative defensibility of current Department of State markup factors
• Evaluating multiple scenarios, narrowing and widening cost corridor guardrails, while assessing gross and net revenue implications
• Analyzing short-term net revenue needs while transitioning to a more defensible, cost-based pricing methodology

A managed care analysis requires intimately understanding payer agreements and payment methodology-related opportunities and risks presented by charge-sensitive contractual agreements. This provides an opportunity to evaluate longer-term revenue risk associated with accountable care incentives, declining utilizations and transparency-motivated charge reduction strategies. In addition, the analysis provides an opportunity to evaluate payer-specific charges and net revenue leakage risks and mitigation strategies.

For a closer look at the forces at play in the health care marketplace and how we can help your organization with price transparency, download our pricing transparency information sheet.

Also, to gain further information about RSM’s pricing transparency capabilities, read this helpful FAQ.