Issue link: https://beckershealthcare.uberflip.com/i/576097
60 FINANCE When is it updated? Once built and organized, the now-full shell of information does not stay static; the chargemaster is a living document. At min- imum, it should be updated on a quarterly basis, but there is need for changes on a daily basis. Departments may need to add or re- move charges, and a regulatory environment in flux demands up- dates. ese "trigger events," such as new CMS guidelines or payer contract updates, can necessitate chargemaster changes beyond a scheduled quarterly review, says Mr. Pillittere. Certain tools placed on top of the chargemaster will scan through the entire document, line item by line item, to identify necessary regulatory updates within a matter of minutes, accord- ing to Mr. Barry. is type of automated technology helps hospi- tals maintain compliance. If a hospital does not have this type of bolt-on, all changes may be handled strictly on a manual quarterly basis, or chargemaster maintenance could be outsourced entirely. Why is it perplexing? CFOs may not nimbly navigate a chargemaster's exhaustive line items, but they do understand the discrepancy between the charges included in the documents and the actual cost of care. "ere is no correlation between pricing and payment," says Mr. Barry. Aer moving to DRG codes, hospitals were no longer paid on a percentage of charges. Instead, payment rates are based on a multitude of factors such as length of stay, level of care adminis- tered and severity of the patient's condition, he says. Discussion of the chargemaster becomes sticky when the question of price transparency arises. It is unlikely a hospital chargemaster will ever become available to the public given the gap between charges and what patients and payers will actually pay. Patients are concerned with their out-of-pocket expenses, not the convoluted backend of healthcare cost structure. Price transparency is coming to healthcare, if at a gradual pace. Hospital leadership can provide that transparency using the chargemaster. "ere are ways to integrate price transparency. You can create a mock bill with current charges using the chargemas- ter," says Mr. Barry. Alternatively, pulling average charges from past claims data can produce a patient payment estimate. Transparency will also force hospital leadership to evaluate whether pricing is fair and competitive, particularly as value-based contracts proliferate. Price transparency and value-based care are just a few of the changes reshaping healthcare. Given this dramatic level of evolu- tion in the industry, could a time come when the hospital charge- master loses relevance? Mr. Barry could envision the chargemas- ter becoming extraneous only if healthcare went to one payment methodology. is scenario is nearly unimaginable; the charge- master will remain the bedrock of hospital cost structure for the foreseeable future. n BECKER'S 7 th Annual Meeting 2016 April 27-30, 2016 | Hyatt Regency, Chicago Register at http://www.beckershospitalreview.com/conference/