Pricing Solutions

Hospitals charging practices are under intense scrutiny. This scrutiny includes a series of lawsuits alleging overcharging of the uninsured, an investigation by the U.S. House Committee on Energy and Commerce and the Hospital Price Disclosure Act of 2005.

Now, more than ever, it is critical for you to implement policies and procedures that comprehensively address the establishment of patient prices. Hospitals should document a carefully considered approach that is consistent with the hospital's overall objectives and mission.

From a financial perspective, pricing methodologies always have a significant impact on your bottom-line. Take care to consider both compliance and financial aspects when establishing patient charges.

Striking a balance between financial performance and defensible pricing methodologies is challenging. Experience shows that revising all prices to reflect a consistent mark-up from cost would result in a severe decrease in net patient revenue. On the other hand, failing to implement a rational, documented pricing methodology exposes you to a range of accusations.

SunStone is well-suited to help you reconcile these conflicting, but equally important objectives. For over 30 years, our consultants have helped clients become more profitable while ensuring compliance with laws, regulations and guidelines. Put our knowledge and expertise to work for you.

Our Objective is simple:

• Develop CDM policies that result in defendable prices without negatively affecting net patient revenue.

Our Approach is straightforward:

• Develop and document your pricing philosophy and objectives to justify patient charges and defend you from inappropriate accusations.
• Develop a charge structure that is compliant with regulations; considers the local market circumstances; and meets your financial requirements and stated philosophy and objectives.

For detailed information about SunStone Consulting Pricing Solutions, please contact either Leonard Brauner at 212-662-9393, or via email at leonardbrauner@sunstoneconsulting.com; or Frank Tokic at 913-897-6620, or via email at franktokic@sunstoneconsulting.com.