Compliance with ONC and CMS rules could offer growth opportunity

It’s understandable if many hospital IT leaders view compliance with a pair of new rules from the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT as chores that must be managed to stay on the right side of the law.

But the CMS Hospital Price Transparency Rule, which took effect on New Year’s Day, and ONC’s Cures Act rules around information blocking and patient access (which start to take effect in April) offer new growth opportunities for health systems that approach them in the spirit they were drafted, a new report from Deloitte shows.

WHY IT MATTERS
“These rules are driving increased data-sharing, and a bigger push is likely to follow,” said Deloitte researchers in the report.

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“We expect the rules to increase competition once consumers are given access to pricing information that can be used to make healthcare decisions and to move the industry toward a consumer-centric future of health. We also anticipate them to drive improved care coordination and quality with clinicians and consumers getting the information they now lack for diagnosis and treatment decisions.”

Therein lie some big strategic opportunities for health systems ready to embrace them, according to Deloitte, which polled 30 executives from large health systems – primarily CFOs and revenue cycle VPs – for the report. 

It found that 62% think the new CMS and ONC rules’ data-sharing requirement will boost care coordination and quality outcomes.

They also recognized the need to invest in consumer experience, and indicated plans to develop new online scheduling capabilities (70%), cost estimation apps (53%) and payment financing options (53%), according to the report.

“Even as health systems work to comply with today’s regulations, they should prepare for future requirements and use these programs as part of their broader competitive, financial, and digital strategies,” said researchers.

According to Deloitte, those preparations should include:

  • market analyses to help drive strategic decisions.
  • new consumer engagement strategies and product design.
  • work with new technology partners.
  • new platforms for tracking and monitoring consumer inquiries.
  • more innovative collaboration with payer organizations.

Broadly speaking, “an improved consumer experience with integrated pricing and quality data presented intuitively can create a strong narrative in the market, which in turn could increase market share,” said researchers.

“Health systems can also improve patient satisfaction and increase trust between patients and providers by providing a simple, comprehensive, and accurate estimate of patient costs. A well-designed digital hospital front door that provides a personalized patient cost estimate, offers financing terms, and an option to schedule the encounter, all in the same digital interaction, can translate into higher point-of-sale collections and overall yield on self-pay accounts.”

Going forward, “health systems should both keep their eyes on meeting short-term requirements and considering strategic opportunities in the longer term,” according to Deloitte. With data sharing and “shoppable services” both on the rise, hospitals health systems should develop “a long-term plan that will help them meet deadlines and create a competitive advantage to succeed in the future of health.”

THE LARGER TREND
Aside from the obvious population health value of the CMS and ONC interoperability rules, there are other ancillary benefits to be had from a more vibrant data sharing ecosystem with more knowledgeable and empowered healthcare consumers.

Deloitte has shown before how more and more providers and payers are going beyond just checking boxes on regulation compliance, with an understanding that broader patient access and improved consumer experience is now a strategic necessity.

The compliance date for Cures Act information blocking provisions is April 5.

In a recent HIMSSCast we discussed how providers and payers should be preparing for them.

ON THE RECORD
“Price transparency and interoperability require significant investments by health systems,” said Deloitte researchers in the report. “Organizations are required to publish standard charges and negotiated rates with health plans for certain services and share patient data seamlessly with consumers, payers, and other providers.”

They added: “Organizations that are most prepared for a long-term journey toward greater transparency and interoperability will likely not only comply with the regulations, but will also approach these steps strategically to gain a significant long-term competitive advantage.”

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