Webinar Pricing Transparency: Implications for Managed Care Contracting

Pricing Transparency: Implications for Managed Care Contracting

CMS’s pricing transparency rule for hospitals went into effect on January 1, 2021. Hospitals are now required to publish a wide range of information about their negotiated rates with payers. But between a pandemic and reluctance to disclose competitively sensitive information, are hospitals even attempting to comply with the rule? And if so, to what extent? How will this impact contract negotiations for both payers and providers? In this webinar, we review ECG’s primary research and discuss key outcomes and implications of publicly available pricing information. We will also outline priority considerations for your pricing strategy in a more transparent marketplace and offer recommendations for your upcoming contracting discussions.

Learning Objectives:

  • Summarize the hospital requirements of the CMS “Transparency in Pricing” rule.
  • Outline the payer requirements of the CMS “Transparency in Coverage” rule, which will take effect on January 1, 2022.
  • Review ECG’s price transparency market research and key outcomes.
  • Provide a case study for a hospital in a “compliant” market to understand how to best use pricing data to support contract negotiations.
  • Understand how payers will likely utilize hospital pricing information. Discuss how to develop a pricing strategy in this new, more transparent environment.