Price transparency is a key focus to have, as the federal government is driving openness to both quality and price data.
In this episode, Greg Kay, Senior Vice President at PMMC, sheds light on his company’s role in ensuring hospitals are paid correctly by payers, negotiating optimal reimbursement terms, and strategically pricing services. Greg delves into the critical area of price transparency, driven by federal regulations, such as the No Surprise Act and Price Transparency Regulations. He emphasizes the importance of compliance, educating consumers on healthcare costs, and leveraging data for hospitals to enhance negotiating positions with payers. Greg also underscores the transformative impact of transparency on the healthcare industry and the need for hospitals to adapt to changing regulations and consumer expectations.
Tune in and learn about the evolving landscape of healthcare reimbursement, compliance challenges, and the pivotal role of organizations like PMMC in navigating these changes!
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[00:00:01] This podcast is produced by Outcomes Rocket, your healthcare exclusive digital marketing agency. Outcomes Rocket exists to help healthcare organizations like yours to maximize their impact and accelerate growth. Visit outcomesrocket.com or text us at 312-224-9945.
[00:00:29] Hey everybody, Saul Marquez with the Outcomes Rocket and welcome back to another episode of the Outcomes Rocket at Becker's Health IT. Today I'm with Greg Kay from PMMC. Greg, thanks for being with us. Absolutely, Saul. Thanks for the invite. Absolutely. Talk to us a little bit about what PMMC does for the healthcare ecosystem. Yeah, absolutely. Our organization focuses in on an accurate reimbursement allowable calculation.
[00:00:54] So we help hospitals ensure that they're being paid correctly by the payers. We help organizations negotiate optimal reimbursement terms. And then we take that allowable to help hospitals provide an accurate estimate to patients, audit reimbursement for accurate reimbursement. And then we look at ensuring that hospitals are pricing their services correctly from a strategic price standpoint.
[00:01:21] Love it. Sounds like very useful information to make sure the books are tight, that cash flow is good, and that everything is working well. Absolutely, Saul. Love that. Greg, here at Becker's we've had a lot of different conversations, whether it's the show floor or the discussions in the rooms. Can you share one insight that you've gained that maybe our listeners and viewers could benefit from?
[00:01:44] Absolutely. One of the areas that we're seeing a lot of interest in today is the changes that are coming with price transparency. There was a session today on price transparency and consumerism. And really, the federal government is driving an openness to both quality and price data. And that's impacting the industry in a couple of different areas. The first is compliance.
[00:02:08] Hospitals need to be compliant with the new requirements so that they are ensuring they're not only meeting the needs of the community, with providing accurate insight to their patients, their consumers, but they're also being compliant with the rules and regulations that are coming down the pipe. The other piece that's driving this is the consumer itself, not only being compliant with what you have to do,
[00:02:34] but really educating the consumer on what health care costs are today before they actually have the service. The federal government has enacted new legislation like the No Surprise Act and price transparency regulations. But on an individual basis, it really comes down to meeting that consumer, helping them understand what their costs are going to be before they actually have the service done.
[00:03:00] And then lastly, it's analyzing this new data that's out there to help hospitals really improve their negotiating position with payers so that they're negotiating reimbursement to ensure that they're being paid for services that they're providing and that they can meet the needs of the community by being adequately reimbursed. So that's probably the biggest insight that I've seen through the sessions here today. Yeah, thank you, Greg. It's a big one.
[00:03:30] And there's certainly a lot of change on the horizon with some of these new requirements requiring transparency. Absolutely. And being able to fulfill the request for that transparency is key. Sounds like you guys are a big part of helping clients do that. For anybody that's curious or interested in doing a better job in these particular areas, or maybe just kind of figuring out more about what you guys do, what's the best place for them to get in touch with you?
[00:03:56] Yeah, our website is pmmconline.com. They could obviously go there, use the contact form. My name is Greg Kaye, and they can find me on LinkedIn or other social media sites. That sounds great, Greg. And by the way, folks, in the show notes, you'll find Greg's contact information, PMMC's contact information. So take action on what you heard today if you got a good idea or you feel like something could help you
[00:04:24] because outcomes begin with action. And Greg, I want to thank you for taking action and being with us today on the Outcomes Rocket. Thank you so much, Sol. This podcast is produced by Outcomes Rocket, your healthcare exclusive digital marketing agency.
[00:04:52] Outcomes Rocket exists to help healthcare organizations like yours to maximize their impact and accelerate growth. Visit outcomesrocket.com or text us at 312-224-9945. 812-224-9945.