Are Hospitals Really Transparent about Pricing?

Many hospitals are choosing which parts of the price transparency rule to comply with and which parts to ignore.

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The Centers for Medicare and Medicaid Services (“CMS”) created a price transparency rule effective January 1, 2021. The rule was aimed at making it easier for patients to shop and compare prices and estimate hospital costs.

The CMS rule requires hospitals to provide clear, accessible pricing information as a complete machine-readable file and in a display of shoppable services in a consumer-friendly format.

According to a recent study, it was determined that since the rule has been in effect, hospitals have been selectively complying.

The study looked at a random sample of hospitals and the 100 hospitals with the highest gross revenue in 2017.

Selective compliance was widespread among the highest revenue hospitals. Of the requirements that were analyzed, 75 of the 100 hospitals were non-compliant with at least one requirement.

Of the random sample, 83 of 100 hospitals were noncompliant with at least one major requirement.

Selective compliance may be ineffective at achieving the goals articulated by CMS. It may fail to allow for price negotiations or even support analysis of the prices.

What has your experience been regarding price transparency? Have you looked at your hospital’s website to determine prices? Is this a tool you have used? Let us know by commenting below!

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