Price transparency has been an ongoing challenge for health systems, and upcoming legislation requiring increased visibility around hospital pricing adds pressure. Meeting the new price transparency requirements means legal compliance, but providing procedure costs, different payment options, and the reasoning behind prices set patients up for an optimal experience, increasing their likelihood to return for future care. With the right tools, such as robust pricing transparency technology and a defensible price strategy, health systems can use the new mandate to take advantage of three key opportunities: Satisfy increasing patient interest in cost of care. Earn patient trust—a short- and long-term imperative. Create the optimal patient experience.

1. Healthcare Price Transparency:
Three Opportunities for
Transformation

2. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency
With health systems, payers, and CMS
contributing to the complex process of
setting and understanding medical
pricing, healthcare price transparency
has been an ongoing challenge for
healthcare organizations.

3. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency
However, as of January 1, 2021, health
systems must publicly provide price
transparency information or face steep
consequences.
Failing to adhere to the new legislation can
result in publicized penalties, corrective
action plans, and monetary punishments.

4. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency
Although the current price transparency
legislation is subject to change based on
new political influences, healthcare
organizations should still prioritize price
transparency because it empowers
patients throughout the care process
and increases the trust a patient places
in a health system.

5. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency
Better transparency means patients are
empowered because they are more
informed about price and quality of care
and will most likely adopt a consumer-
driven approach to future care decisions.

6. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency
The consumer mentality in healthcare
opens the doors for increased
competition between health systems,
tantamount to organizations losing
patients and revenue to competitors
if they fail to consider a consumer-
driven approach to pricing in their
transparency strategy.

7. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency
To comply with the new CMS-backed
price transparency legislation, health
systems must provide standard
charges via machine-readable files
and a consumer-friendly display of
shoppable services.

8. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency
Meeting these rigorous healthcare price
transparency standards demands that
health systems have robust price
transparency technology (e.g., the
Vitalware Hospital Price Index) that can
organize and display an organization’s
chargemaster, list of shoppable services,
and a list of all services.

9. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency
Along with the price transparency
technology, health systems must develop
and communicate a defensible pricing
strategy (DPS) to convey the reasoning
behind the cost of care.

10. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
With the price transparency technology and DPS
in place, health systems are not only prepared to
meet CMS’s cost requirements, but they can also
use price transparency to take advantage of three
critical opportunities:
1. Satisfy Increasing Patient Interest in Cost of Care
2. Earn Patient Trust—A Short- and Long-Term
Imperative
3. Create the Optimal Patient Experience

11. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#1: Satisfy Increasing Patient Interest in Cost of Care
As patients become more involved in their
care, they become more engaged in
understanding the cost of care.
In the past, patients often went to the most
accessible or recommended provider with
little investigation.

12. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#1: Satisfy Increasing Patient Interest in Cost of Care
Now, patients conduct in-depth internet
searches to compare different health
systems, provider ratings, procedure
alternatives, and cost.
Just like a consumer shops for the best
deal on a car, a patient now shops for
the best deal or outcome for some
procedures.

13. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#1: Satisfy Increasing Patient Interest in Cost of Care
As healthcare costs continue to rise,
patients only grow more curious and
committed to learning about their options,
becoming highly educated and more in
control of their care.

14. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#1: Satisfy Increasing Patient Interest in Cost of Care
The changing reimbursement landscape
that requires patients to pay more out of
pocket for procedures is also piquing
pricing curiosity.
Paying more for care incentivizes
patients to understand what type of care
they receive and the associated cost.

15. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#1: Satisfy Increasing Patient Interest in Cost of Care
In short, when patients have to pay, they
review and scrutinize every charge on a
bill and inquire about the reasoning
behind the price.

16. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
Although the new healthcare price transparency
legislation requires health systems to share
pricing structure, providing patient-friendly
information around cost structure is also an
opportunity to create and deepen patient trust.
Price transparency can increase trust
between patients and health systems
by helping patients understand what
they are paying for.

17. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
For example, rather than receiving an
explanation of benefits (EOB) after a high-
charge procedure, health systems can
provide cost information before procedures.
With a proactive approach to cost
disclosure, health systems give patients
time to financially prepare, research
payment options, and select the right
payment plan.

18. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
Price transparency also avoids confronting a
patient with surprise bills after a procedure,
fostering trust between the patient and the
health system.
For example, when a patient receives a bill
from a health system or payer, he might be
confused about the amount and why he
owes anything.

19. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
In many instances, the patient has already
met his deductible and paid the co-pay, yet
he still receives a costly bill that he doesn’t
understand and didn’t expect.
Explaining the bill before the procedure—
and especially before the patient gets the
bill—ensures the patient that the health
system is doing everything it can to help
the patient pay for the procedure and
understand the financial ramifications if
the patient cannot pay.

20. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
Providing thorough information about the
pricing model and DPS in simple terms also
builds patient trust.
For example, if a patient is going to pay for a
knee replacement, she wants to understand
every subitem (e.g., inpatient charges related
to hospital stays and any associated fees)
within the total procedure cost.

21. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
She might shop around to learn more about
a health system’s reputation and outcomes
and might even be willing to pay more
based on higher ratings.
If the pricing information is clear and
defensible (every line item within the cost
makes sense and has an easy-to-
understand reason), patients are more
likely to trust what the health system
charges for care.

22. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
When more health systems provide price
transparency, patients will know which
hospitals charge less money for certain
procedures.
This insight incentivizes health systems to
drive down cost and deliver quality care,
another benefit for patients.

23. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
Additionally, health systems can use price
transparency to their advantage by
showing patients the fair prices they
charge for care compared to market
prices, increasing a patient’s willingness
to trust the health system.

24. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
Organizations also have more incentive
to be upfront about cost, and in some
cases, offer discounts for cash payment,
to avoid situations where patients do not
or cannot pay the cost after a procedure.
With unpaid bills, health systems
have no way to go back and create
a financial plan, increasing the
chance of incurring bad debt.

25. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#2: Earn Patient Trust—A Short- and Long-Term Imperative
When patients know the cost before
the procedure and have time to select
a payment plan, they are more likely
to pay their bill.

26. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#3: Create the Optimal Patient Experience
A key component of delivering an excellent
patient experience—thereby building a
loyal patient base and future referrals—is
sharing cost information up front.

27. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#3: Create the Optimal Patient Experience
The patient experience includes how a
health system and its team members treat
patients when they’re at the hospital and
how an organization provides thorough
information about the cost of care.

28. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#3: Create the Optimal Patient Experience
Informing patients about procedural costs
and payment options is critical in treating
patients with the highest quality of care and
setting patients up for the best outcomes.

29. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#3: Create the Optimal Patient Experience
Pricing transparency gives patients an
active role in their care process, allowing
them to explore options and choose the
best-suited health system or provider
rather than letting a referral from a
primary care provider direct where they
receive care.

30. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Provides
Three Key Opportunities
#3: Create the Optimal Patient Experience
When patients understand their role in
their health and care plan, they
collaborate with the care team and
share accountability, and the team
focuses on providing the patient every
opportunity to attain optimum health—
a foundation for building an excellent
patient experience.

31. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Sets Patients and
Health Systems Up for Success
Price transparency has been an ongoing
conversation as healthcare organizations
strive to understand what a patient needs
to know to make informed care decisions
and the best way to pay for care.
With a strong price transparency strategy,
health systems can provide every
opportunity for patients to find the best
care at the lowest cost.

32. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Sets Patients and
Health Systems Up for Success
By publicly providing cost information,
payment options, and sound justification
behind procedure prices in advance,
health systems comply with the new
healthcare price transparency legislation
and improve their relationship with their
patient populations.

33. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Sets Patients and
Health Systems Up for Success
The new legislation can be a hurdle for
some systems lacking the technology
and pricing strategy.
Still, it can be an opportunity to engage
patients throughout the care process,
deepen patient trust, and provide the
ideal patient experience.

34. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Healthcare Price Transparency Sets Patients and
Health Systems Up for Success
An effective price transparency
strategy sets both health systems
and patients up for success,
increasing the likelihood that
patients will return to the same
facility for future care, refer family
and friends, and drive more
business to that health system.

35. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

36. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
More about this topic
Link to original article for a more in-depth discussion.
Healthcare Price Transparency: Three Opportunities for Transformation
Healthcare Relief Funding: Five Steps to Maximize COVID-19 Dollars
Greg Anderson, CPA/ABV, CVA, HORNE LLP; Jeff Grandia, MBA, Senior VP, Sales
Healthcare Revenue Cycle: Five Keys to Financial Sustainability
Marlowe Dazley, Senior VP and Managing Director of Financial Advisory Services;
Todd Halpin, Senior VP, Financial Advisory Services
Reduce Bad Debt: Four Tactics to Limit Exposure During COVID-19
Marlowe Dazley, Senior VP and Managing Director of Financial Advisory Services
An Effective Financial Response to COVID-19: Three Ways to Leverage Data
Steve Vance, MBA, FHFMA, MBA, FHFMA, Senior VP, Professional Services
Activity-Based Costing in Healthcare During COVID-19: Meeting Four Critical Needs
Bob Alexander, Implementation Services, Sr. Director

37. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Marlowe Dazley is Senior Vice President and Managing Director at Health Catalyst,
responsible for financial advisory services providing strategic financial management
expertise and consulting for healthcare payers and providers. Prior to joining Health
Catalyst, Marlowe lead PNC Bank’s healthcare consulting division. Mr. Dazley has 30
years of healthcare experience in various organizations, including the office of the U.S.
Surgeon General, managed care operations, finance, administration, and consulting.
He has worked as a healthcare consultant since 1996, for Ernst & Young in the Los Angeles healthcare
consulting practice, Phase 2 Consulting and Premier. Marlowe has participated in numerous strategic
planning engagements, mergers and acquisitions and performance improvement initiatives and has led
numerous financial turnarounds for clients across the country specializing in healthcare strategy,
revenue cycle improvement and financial operations initiatives. Mr. Dazley received a dual Master of
Business Administration and Master of Health Services Administration from the University of Utah. He is
a member of the Healthcare Financial Management Association and has performed numerous speaking
engagements at local regional, and national levels for HFMA including HFMA’s Annual National
Institute. In addition, he delivers numerous addresses to the University Health System Consortium,
State Hospital Associations, hospital boards and medical staff and various other industry leaders.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Marlowe Dazley

38. © 2020 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement
company that helps healthcare organizations of all sizes improve clinical, financial, and operational
outcomes needed to improve population health and accountable care. Our proven enterprise data
warehouse (EDW) and analytics platform helps improve quality, add efficiency and lower costs in
support of more than 65 million patients for organizations ranging from the largest US health system
to forward-thinking physician practices.
Health Catalyst was recently named as the leader in the enterprise healthcare BI market in
improvement by KLAS, and has received numerous best-place-to work awards including Modern
Healthcare in 2013, 2014, and 2015, as well as other recognitions such as “Best Place to work for
Millenials, and a “Best Perks for Women.”