Study: Majority of hospitals fail to meet CMS’ price transparency requirements
Most hospitals are noncompliant with CMS’ Hospital Price Transparency final rule, according to a study published June 14 in JAMA. Out of a random sample of 100 hospitals, 83 were noncompliant with at least one significant requirement.
The rule, effective January 1, requires hospitals to post their standard charges online in a single machine-readable file and as a separate, consumer-friendly listing of 300 shoppable services. Standard charges, as defined by CMS, include the following types of charges:
- De-identified minimum and maximum negotiated charges
- Discounted cash prices
- Gross charges
- Payer-specific negotiated rates
Hospitals may meet the requirement to post a separate list of 300 shoppable services by offering a consumer-friendly price estimator tool.
The study found that, of the sample of 100 hospitals, only 33 posted payer-specific negotiated rates. Compliance with the requirement to post discounted cash prices was even lower, with only 30 hospitals providing that information. However, 52 hospitals offered a price estimator tool that fulfilled the requirement to post a separate list of 300 shoppable services.
CMS’ relatively low penalty for noncompliance—$300 per day—may be one cause of low compliance, the study authors suggested. The COVID-19 pandemic may also have played a role, although the study authors pointed out that rule was finalized before the pandemic and hospitals had more than a year to prepare. Low compliance this early suggests that noncompliance will continue to be an issue, according to the study authors.
Hospitals should review the rule and their efforts to comply. Revenue integrity professionals should ensure published charge data is up to date and that processes are in place to allow for regular updates and reviews.
Editor’s note: Find more of NAHRI’s price transparency coverage and resources here.