Streamlining Price Transparency Efforts? CMS Is Trying to Help

CMS recently released sample formats for hospital price transparency files to help revenue cycle leaders comply with the requirement.

As price transparency requirements push forward and with a wide lack of adoption from hospitals, CMS is trying to help revenue cycle leaders streamline their processes by offering sample formats.

CMS is offering three voluntary sample formats (wide, tall, and plain) that hospitals may use to meet the federal requirement to make certain standard charges publicly available through a machine-readable file.

At the same time, CMS also posted a sample data dictionary for the wide and tall formats.

While some organizations already have systems in place to adhere to price transparency requirements, opportunities still exist to adjust outdated revenue cycle processes, including creating the necessary machine-readable file.

"Revenue cycle leaders need to first make sure they are following CMS' guidelines to complete a comprehensive, machine-readable file of all services and items," Connie Lockhart, director of strategy and operations at Impact Advisors, said. 

"Ensure all requirements are met—like how a separate file must be posted for each hospital. And be cognizant of multiple hospitals operating under a single hospital license with different sets of standard charges."

Also, ensure that list is posted on a publicly available website.

Once completed, make sure to post a display in a publicly available website of 300 shoppable services in a consumer-friendly format. This should include the 70 CMS-specified, shoppable services, Lockhart says. Revenue cycle leaders should also establish a cadence to ensure both displays are updated annually, Lockhart says.

Once the basics of price transparency are in place, like creating a machine-readable file, revenue cycle leaders can then move to streamlining other areas of the requirement.