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Price transparency and price estimates have been two critical focus areas for El Camino Hospital’s financial services team for more than two decades.
“Since 1996, we have offered cost estimates to any patient or prospective patient who called our office requesting one,” says Karla Romero, manager of patient access at the 420-bed hospital in Mountain View, CA. “We have experienced a steady increase in the number of patients and prospective patients wanting to know what their out-of-pocket cost will be.”
This is because of the surge in high-deductible plans. “Consumers want to be able to make informed financial decisions about where they go for care,” Romero explains. Patients must plan for their medical expenses in advance of a procedure or hospital stay. Many callers reported searching in vain online for price information. “We wanted to find a solution that would allow patients to run their own personalized cost estimate,” Romero reports.
The department’s online price estimator tool launched in August 2017. It allows both current and prospective patients to instantly run an estimate based on their insurance benefits, the hospital’s charge master, and contractual agreements with payers. The tool offers estimates for 90 services and procedures and 11 surgeries. For more complex surgeries, patients work with a financial counselor to learn their out-of-pocket costs.
“Since we launched the online self-service option, there have been more than 3,000 queries run using the tool,” reports Terri Manifesto, senior director of El Camino’s revenue cycle. Patients expect more than just a rough idea of their charges. “They want to know the exact amount of their future bill,” Romero stresses.
Patient access has to explain their limitations in this regard. Only an estimate, based on the information available at the time, is possible. Once patients see a dollar amount, many ask another question, Romero says: “We’re seeing an increase in people asking for additional discounts.”
Many hospitals still offer only an average cost for a particular service, but Manifesto says El Camino’s estimates “are between 95% to 99% accurate.”
Still, employees caution that things can change.
“The final cost will be different if the deductible status or insurance changes, or if services ordered by the patient’s doctor differ,” Manifesto cautions.