Our commitment to pricing transparency and helping health care consumers understand their costs

Our commitment to pricing transparency and helping health care consumers understand their costs

Providence believes price transparency is essential to improving health care in the U.S. Patients and consumers deserve transparency that delivers what they need to make informed decisions about their care, and we are dedicated to helping them understand their costs.

As required by the federal pricing rule and the Centers for Medicare & Medicaid Services (CMS), which is the agency enforcing the rule, all Providence hospitals have posted their payor-negotiated rates and complete chargemasters, as well as launched an online price estimator for the top 300 shoppable services.

Patients and consumers want a quick and easy way to understand costs and what they’ll be billed or asked to pay for care. We offer a variety of tools and services to help patients get a better, faster understanding of their out-of-pocket costs.

Providence hospitals have long provided customized out-of-pocket estimates for our patients and together with the online price estimator, we help make this process self-serve and available to them 24/7. Our online price estimator gives patients estimates tailored to their insurance coverage and preferred hospital, and patients without insurance can get an estimate of their discounted cost. Additionally, patients who are uninsured, underinsured or otherwise unable to pay for their care are encouraged to apply for financial assistance to reduce or eliminate their costs of care.

Our solutions are patient-centric and meet the requirements under CMS transparency rules for shoppable services. While we did post our negotiated rates with payors and complete chargemasters in a machine-readable file format, we believe the price estimator tool is more helpful to patients and health care consumers because the CMS-required machine-readable files are complicated lists of charges and prices that don’t reflect their personal costs. Additionally, the CMS-recognized format for these files and their size may require technical applications that a typical consumer does not have.

Providence supports CMS’ overall intent to increase transparency for consumers and we are hopeful that future policy direction will encourage collaborative solutions in the best interests of all health care consumers. More improvements to health care cost transparency can be achieved by inviting all stakeholders to work together in the best interests of patients across the U.S. All health care entities contribute to the cost of care or how information about those costs are made available, and all can contribute to enhanced price transparency that responds to what consumers most need.

As part of an ongoing commitment to improve pricing information and the health care experience for our patients and consumers, we will continue to evaluate and enhance the ways we make estimates available. We are monitoring for changes in CMS price transparency requirements to ensure we maintain compliance and so that we are providing tools and solutions that best support our patients. If we determine changes are required to meet the rule’s requirements, we will make those adjustments. At Providence, everything we do centers on the people we serve and we are dedicated to helping our patients understand their costs.

You can find Providence hospitals’ pricing data online: www.providence.org/obp/pricing-transparency.

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