How to develop a holistic approach to pricing
Editor’s note: Luis Aguilar and Gregg Fanselau, MBA, will present “Optimizing Hospital Pricing Strategies: Balancing Transparency, Reimbursement, and Family-Owed Costs in an Ever-Changing Market” on day two of the 2025 Revenue Integrity Symposium (RIS), which will take place September 25–26 in Westminster, Colorado. Aguilar is a pricing analyst at Children’s Hospital Colorado in Aurora, Colorado, and Fanselau is a reimbursement consultant, advanced, Children’s Hospital Colorado. Use NAHRI’s justification letter template as a guide to gain your organization’s support for attending.
Q: In what ways does your session challenge attendees to think outside the box?
Aguilar and Fanselau: Children's Hospital Colorado uses a holistic pricing approach that takes into account competitive pricing, market fluctuations, and the financial burden on patients. This strategy ensures that pricing is fair and responsive to both market conditions and patient needs. By considering these factors, we are able to think outside the box, exploring innovative solutions to provide accessible care while maintaining financial sustainability.
Q: What’s the biggest challenge in revenue integrity and/or revenue cycle right now? How does your session help tackle this?
Aguilar and Fanselau: Political requirements, such as changes in healthcare policies, funding cuts, and regulatory compliance, are increasingly impacting hospitals by straining resources and demanding more administrative work. Revenue integrity can tackle this by staying proactive in adapting to policy changes such as pricing transparency and looking ahead at what may come to be prepared to move quickly where necessary.
Q: What’s one of the key pieces of information you would like people to take away from your session?
Aguilar and Fanselau: It is essential to analyze your facility’s prices from multiple perspectives: reimbursement, compliance, rational relationship between similar services, public perception, provider concerns, payer policies, competitor prices, and, of course, reimbursement opportunities.
Q: What are you most excited about for this year’s conference?
Fanselau: I am looking forward to many of the breakouts, but especially “Revenue Integrity Key Metrics and Reporting”, “Status Check: Rethinking Patient Status Corrections,” and “Key Performance Indicators: Everything You Are Told Is Wrong.” Also hoping to meet counterparts from other organizations
Q: What's a great piece of advice you've received regarding revenue integrity and/or revenue cycle? Or, what advice do you like to give people about revenue integrity and/or revenue cycle?
Aguilar and Fanselau: If you envision your facility as one human individual, revenue integrity is connective tissue. It touches clinical areas, patient financial services, finance, managed care, compliance, legal, IT—basically every functional area.