Only 5.6% of hospitals comply with price transparency rule

The vast majority of hospitals are not following through on a recent requirement to publish their list prices online, according to a recent study from PatientRightsAdvocate.com.

The findings were published just before the Centers for Medicare and Medicaid Services proposed increasingly painful monetary penalties against hospitals that fail to publish their prices. The hospital industry has been against posting prices and sued to get the rule overturned. However, the mandate to increase price transparency went into effect January 1, 2021. 

Research analysts from PatientRightsAdvocate.com assessed websites for hospital compliance, finding 94.4% of hospitals were noncompliant. PatientRightsAdvocate.com reviewed a random sample of 500 hospital websites for its study. Just more than 6,000 hospitals were impacted by the new rule to publish prices of 300 services.

“Our review of hospital compliance with the rule found widespread failure of hospitals to report prices from all payers and plans,” the study reads.

Of the 500 sampled, only 28 were found to be in compliance. The majority of hospitals that were deemed noncompliant failed to post all payer-specific and plan-specific negotiated rates, while others had incomplete or missing data fields, or fields with zeros, N/A’s and asterisks for negotiated rates. Hospitals also frequently listed at “a separate location on their website far more accepted insurance plans for coverage than they showed in their standard charges file, implying that their standard charges file did not include all accepted plans,” the study read.

The study reveals that hospitals may be unwilling to take on the price transparency rule in earnest, instead opting to take the penalties. 

“These findings align with previous research indicating that hospitals are undermining the rule with incomplete information,4 burdensome access restrictions, code to block prices from being displayed on search engines, and tools to obfuscate access to mobile app developers and to patients,” the study concluded. 

PatientRightsAdvocate.com noted there are several ways to improve compliance, including higher monetary penalties–as was recently proposed by CMS; enhanced requirements for the list of 300 shoppable services; requirements for actual prices, not estimates; and requirements for clear pricing data standards.

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