- Despite CMS issuing a new rule requiring hospitals to publish their prices for many services as of Jan. 1, few of the larger institutions are making such data readily available, according to a new study published in JAMA Network Open.
- Researchers found that fewer than half of the nation's hospitals had chargemaster data on their websites. Moreover, among 25 common items and procedures posted by the 100 largest hospitals, far fewer than 20% had decipherable pricing for any single item. The highest rate of compliance, for a basic metabolic panel, was below 40%.
- The study's authors noted that "even when publicly accessible, chargemasters were frequently buried within websites and difficult to use accurately," and concluded that "this work calls into question the effectiveness of CMS rulings to promote price transparency and highlights the challenges of creating effective price transparency tools for consumers."
Hospitals fiercely fought a rule CMS finalized last fall requiring facilities post many of their negotiated prices with insurers for various services. The new study, authored by researchers from the University of Texas, Johns Hopkins University, Southern Methodist University and the William Carey College of Osteopathic Medicine, concludes that few are really complying with the mandate anyway. The study echoes data recently reported in a separate Health Affairs survey.
The study identified nearly 5,300 acute care and psychiatric facilities that had websites. Of those, 51.5% did not have a chargemaster in a machine-readable format, which is required under the new CMS rule. More than 300 institutions "had broken links or incorrectly linked files," and 138 hospitals only had online cost estimators.
Hospitals with higher scores from patients and nonprofit institutions were more likely to have posted prices than for-profit or psychiatric facilities.
Moreover, the study drilled down on specific pricing at the 100 large hospitals in the U.S. They were assayed by two different researchers, who both focused on 25 different items on the chargemasters. Altogether, they identified 330 different prices for the items.
However, few found prices at the same hospitals that they agreed matched. The influenza vaccine had the greatest match rate among the hospitals — less than 20%. For a basic metabolic panel, prices unearthed by the researchers did not match nearly 40% of the time.
"Additional data, including negotiated rates mandated in the final rule on price transparency, may improve the interpretability of hospital prices, but that rule does not address improving access and usability of hospital pricing data," the study concluded.
Under another CMS final rule, health insurers will have to begin posting their negotiated prices in a consumer-friendly format beginning in 2023.