Date of Award

2023

Degree Name

Healthcare Administration

College

College of Business

Type of Degree

M.S.

Document Type

Research Paper

First Advisor

Alberto Coustasse

Abstract

Introduction: This research delves into the critical examination of hospital chargemasters, exploring their intricate role in the complex landscape of healthcare finance. As the healthcare industry grapples with the challenges of balancing medical care and fiscal responsibility, the hospital chargemaster emerges as a dynamic entity, reflecting the interplay between healthcare providers, insurers, and patients. Beyond being a mere ledger of prices, the chargemaster influences the entire Revenue Cycle Management (RCM), impacting financial stability, patient satisfaction, and the effectiveness of healthcare delivery. Originating from the necessity to navigate reimbursement complexities, the chargemaster has become central to hospitals' financial strategies, shaping and being shaped by evolving healthcare regulations and patient-centric models. This multidimensional exploration seeks to unravel the intricacies of chargemasters, offering a comprehensive understanding of their influence on the broader framework of revenue cycle management and the delivery of quality healthcare services.

Methodology: The primary hypothesis for this research was that the lack of transparency in chargemaster pricing significantly influences operational costs and plays a pivotal role in shaping healthcare spending. The methodology for this research study was a qualitative literature review and an anonymous survey completed by an employee at a hospital. Institutional Review Board approval was obtained prior to the anonymous survey being submitted.

Purpose: The purpose of this research was to provide a comprehensive understanding of chargemasters, emphasizing their impact on various aspects of the healthcare system, including operational costs, revenue generation, patient costs, healthcare accessibility, and patient satisfaction.

Results: This finding of this research revealed that hospitalization fees, directly tied to inpatient clinical management, constitute the largest proportion of operational costs and significantly impact chargemaster rates. Operational costs related to staffing, medical supplies, equipment, technology, facility maintenance, and administrative overhead collectively shape the financial landscape of healthcare provision. Furthermore, the analysis indicates that the lack of transparency in chargemaster pricing contributes to inflated healthcare spending. This focused exploration underscores the intricate relationship between operational costs and chargemaster rates, offering insights into the financial dynamics of healthcare services and the implications for overall cost management.

Discussion/Conclusion: This study illuminated the detrimental impact of chargemaster pricing on healthcare finance, revealing how operational costs intricately shape chargemaster rates and contribute to the escalating cost of healthcare services. The study emphasized the urgent need for standardized practices, transparency, and regulatory interventions to foster a fair, affordable, and efficient healthcare financial landscape.

Subject(s)

Health services administration.

Health facilities -- Business management.

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