Understanding Costs and Supporting Transparency-Keys to Quality Care

Area of Science:

• Healthcare Management
• Health Economics
• Health Informatics

Background:

• Demonstrating value is crucial for healthcare organizations' future success.
• Understanding the true cost of care is essential but historically challenging due to system limitations and consumer payment models.
• Health systems must adapt delivery models to meet evolving consumer demands for transparency and affordability.

Purpose of the Study:

• To outline challenges and opportunities in determining and reducing the total cost of care.
• To highlight the importance of translating cost information for consumer payments.
• To showcase initiatives in price transparency and digital consumer engagement.

Main Methods:

• System-wide transition to a single electronic health record (EHR) platform.
• Transformation of care models and billing platforms.
• Development of price transparency tools by an integrated health plan.

Main Results:

• Spectrum Health is addressing the challenge of determining total cost of care.
• Integrated systems facilitate higher quality care and outcomes.
• Initiatives are underway to provide consumers with pricing information and digital engagement tools.

Conclusions:

• Successfully demonstrating value requires understanding and reducing the total cost of care.
• Integrated health records and billing systems are key to achieving efficiency and quality.
• Price transparency and consumer-facing digital tools are vital for engaging individuals in their health and financial well-being.