Report: Only 25% of US Hospitals Provide Full Price Transparency

A new report has found that despite two years passing since the hospital price transparency rule was announced, only one in four US hospitals is complying with it.

Patient Rights Advocate announced the findings of its latest price transparency study, which included a survey of 2,000 hospitals throughout the country. A rule requiring hospitals to advertise pricing for some items and services was found to be fully complied with by less only 24.5% of the hospitals, down from 16.5% in the previous report in August 2022.

According to the report, “This blatant obfuscation of prices and flouting of the rule demonstrates that implementation and enforcement efforts must be rigorously examined and markedly strengthened to improve compliance, enable technology innovators to parse the pricing data, and empower American consumers with upfront prices.”

On January 1, 2021, the rule mandating the disclosure of a machine-readable standard charges document for all goods and services provided by U.S. hospitals to all payers came into effect. Additionally, hospitals must either list the pricing for 300 individually priced services or provide a price estimate tool.

Most U.S. hospitals were verified to have online records. But the major cause for significant noncompliance is that such records are either insufficient or unreadable, or lack clearly connected costs for both the provider and the plan. In fact, 116 hospitals – accounting for 5% – didn’t provide any standard charge documents at all.

The report also claims that several major healthcare organizations, including UPMC, HCA Healthcare, and UnityPoint Health, do not have a single hospital that is in complete compliance. Of the hospitals that did comply, nearly 55% were Commonspirit while almost 75% were owned by LifePoint Health.

Patient Rights Advocate has demanded that the Department of Health and Human Services crack down harder on U.S. hospitals that don’t adhere to the regulations regarding compliance. According to the report, just two hospitals have been punished by HHS since the rule’s implementation, despite the fact that thousands more are likely to be non-compliant.

Healthcare facilities that fail to comply with the regulation will be penalized, as per the Centers for Medicare & Medicaid Services. In June 2022, the first hospital system to be punished by CMS for noncompliance was the Northside Hospital system in Atlanta, Georgia, for over $1 million.

The hospital sector strongly objected to the HHS’ pricing transparency regulation and filed a lawsuit to block its implementation. Many healthcare facilities and networks have complained that the rule is too costly and ambiguous to apply.

Although insurers have mostly cooperated with a comparable regulation that compels them to disclose pricing data, hospitals continue to have trouble meeting the requirements of the hospital price transparency rule. Researchers and campaigners have protested to the Biden administration that the data is often not usable and difficult to comprehend.

The Centers for Medicare and Medicaid Services have been asked by a group of researchers to make certain technical adjustments to the requirements so that they can better assist with the problem. Also read, the latest news on Hospital & Providers by clicking here