Pricing transparency is here, but has it made a difference in service line volume and ROI?  Is there a way to make the charge master relevant again, grow sales, and increase ROI?

The mandate for pricing transparency was based on the predicate that consumerism would do for health care what it has done for (and to) other industries. It is not the home run the feds expected, but it has changed what some consumers see before scheduling an initial in-person or virtual engagement with a physician provider.

Reducing inflated contractual allowances resulting from years of fixed percentage across-the-board price adjustments is the quickest way to make the charge master relevant again and restore the important ratio of costs-to-charges (the RCC).

Should you also reduce some charges? The short answer is yes, but this should be only after completing a fresh market analysis of charge master pricing and the minimum payment each payer will accept. In addition, we recommend a thorough internal analysis of high volume and the more profitable service lines.

It’s an imperative to check payer reimbursement rates for each service line potentially affected to ensure a reduction in the posted charge does not impact reimbursement.

It also makes sense to check physician alignment, physician recruiting, and the on-boarding status of any newly-recruited physicians before adjusting charges.

This combination of analyses and checks will deliver a strategic charge master that is both a market differentiator and a true revenue-generator once again.

See what Q can do for you!