Bringing Transparency to Patient Financial Communications

The Healthcare Financial Management Association (HMFA) recently announced comprehensive guidelines aimed to bridge the communication gaps between patients and health care professionals. The criteria mainly deal with pricing transparency on the part of health care providers.

These guidelines, called the Patient Financial Communications Best Practices, took a year to develop and were headed by former Health and Human Services Secretary Michael Leavitt. The project was a collaboration of several groups such as the American Hospital Association, America’s Health Insurance Plans, the American Academy of Family Physicians and the National Patient Advocate Foundation. Policymakers, such as Sens. Bill Frist and Tom Daschle, and patient advocacy groups also acted as advisors in the process.

“The best practices bring consistency, clarity and transparency to talking with patients about their health care costs,” Leavitt said in a statement.

According to the authors, the goals of these procedures are so that, “patients understand the cost of services they receive, their insurance coverage, and their individual responsibility.”

The established guidelines cover the following:

• Financial counseling

Patients will know their options involving care, including financial requirements. When available, health care providers should refer patients to financial resources.

“Provider organizations will have clear policies on how to interact with patients with prior balances choosing to have elective or non-elective procedures,” according to the authors.

• Type of care

Patients will be thoroughly informed of whether the care they intend to receive is elective or non-elective

• Accommodating patients

Patients will be treated in an ethical manner. This includes support of patients of different languages and education, and holding face-to-face interactions whenever possible.

According to the HMFA, these standards “help patients understand the cost of services they receive, their insurance coverage, and their individual responsibility.” These guidelines are expansive, as they apply to patients “before service, in the emergency department and in other care settings.”

Pat Keel, executive vice president of Good Shepherd Health System, applauded the project for its collaborative efforts.

“Because the plan included representatives from hospitals, physician practices, collection agencies, patient advocacy groups and government entities, participating as part of this steering committee gave many of us a broader perspective of the process,” Keel said in a statement.