PYA Principal Bob Paskowski, Senior Manager Kathy Reep, and Director of Business Intelligence & Analytics Jason Hardin presented “Price Transparency—Using the Data” at the Multi-State Managed Care Conference. The event brought together hospital associations from Florida, Georgia, Tennessee, and North and South Carolina.
As of January 2021, hospitals must comply with price transparency requirements issued by the Centers for Medicare & Medicaid Services (CMS). These requirements included posting on a website a machine-readable file containing payer-specific negotiated rates and a second file with at least 300 shoppable services.
PYA addressed the new penalties for non-compliance and examined common errors providers have made in posting the files. And, as more and more providers are posting their data, they discussed how hospitals are using that information in benchmarking negotiated rates. In this session, Bob, Kathy, and Jason:
- Reviewed the CMS requirements related to the posting of rates.
- Shared insight into identified errors in the current data.
- Shared insight into hospitals’ negotiated charges for their contracted payers.
- Examined variation in pricing for similar healthcare services.
- Explored PYA’s new “Negotiated Pricing Dashboard” to share the utility by hospitals.
The conference was held in Asheville, North Carolina, from April 20-22, 2022. View the slides here.
If you would like assistance with price transparency issues, or any matter involving compliance, valuation, or strategy and integration, one of our executive contacts would be happy to assist. You may email them below, or call (800) 270-9629.