New federal regulations aimed at hospital price transparency could significantly affect outreach laboratories. Although the changes might not be wholly welcome, they could prod the industry in a more patient-focused direction, says Jane Hermansen, MT(ASCP), manager of outreach and network development at Mayo Clinic Laboratories.
"I think the regulation is needed, and I think that as an industry it is about time that we provide patient-focused information," Hermansen tells 360Dx.
Due to take effect next Jan. 1, the transparency rules from the Centers for Medicare & Medicaid Services require hospitals to annually post online "all standard charges," including commonly ordered tests such as metabolic panels, lipid panels and complete blood counts.
Hermansen questions how far this information would go toward helping patients assess their actual out-of-pocket costs. "There almost needs to be an algorithmic flowchart of questions to ask—'Who is this patient? What is their insurance? If they have met their deductible, what percentage is their co-insurance?'" Hermansen says.
However, many hospitals already have the tools to answer those questions. "Those are pretty routine and rapid procedures," Hermansen says.
She suggests that whatever pricing or competitive pressures the law might exert, moving toward price transparency would benefit labs overall.
"You have the back end of dealing with a patient who says, 'I got a $20,000 bill for a strep culture. You must be kidding me,'" she says. "When you think about all the angst and bad press that comes from a situation like that, would the lab have been better served by just being upfront and saying, 'Here is what you're going to be paying for this service?' The challenge for us is to design our systems in such a way that we give patients the information that is relevant to them."
Read "Labs Brace for Potential Plusses, Minuses of Price Transparency Regulations" to learn more.