- An analysis of 1,000 U.S. hospitals found that only 14.3% were complying with federal price transparency rules and about 38% of hospitals posted a "sufficient amount of negotiated rates" on their websites.
- The PatientRightsAdvocate.org analysis follows a report in July 2021 that showed only 5.6% of 500 random hospitals were in compliance with the rules that were introduced at the start of 2021.
- "The largest hospital systems are effectively ignoring the law with no consequences," the 61-page report said, noting that only two hospitals of 361 at three of the largest hospital systems were in compliance.
Price transparency in healthcare has been an objective among policy experts and economists to encourage a more competitive and efficient market for medical treatment, as the CMS forecasts national health spending to grow at an average rate of 5.4% through 2028. Health plans and other payers have designed online tools to steer their beneficiaries to low-cost options for medical procedures and for pharmaceuticals.
That hasn't stopped many hospitals from charging widely varying fees for procedures even within in the same hospital. In some cases, some patients would have received a better rate by having no coverage, according to a New York Times article in July.
A federal price transparency rule required hospitals to post all prices online starting Jan. 1, 2021, with a list of standard charges for all items and services for all payers and all plans, as well as discounted cash prices and a standard list or price estimator for the 300 most common procedures. The hospital industry had challenged the rule through lobbying and litigation.
PatientRightsAdvocate.org, a nonprofit organization dedicated to systemwide healthcare price transparency, said its analysis raises the need to penalize and enforce against noncompliance, and illustrates why clearer pricing is necessary. No hospitals have been reported to have been issued a penalty for noncompliance, the report said.
The group said that widespread availability of hospital pricing data combined with July's transparency rules regarding health coverage will "unleash the benefits of competition to foster a functional marketplace in healthcare and health coverage."
The report said only two of 361 combined hospitals at three of the largest hospitals systems — HCA Healthcare, CommonSpirit Health and Ascension — were estimated to be in compliance with the federal standard.
HCA spokesman Harlow Sumerford said its hospitals have "worked diligently and have completed our implementation of these requirements. Our hospital websites have a consumer-friendly Patient Payment Estimator tool that provides relevant information to help patients understand what their out-of-pocket costs may be for hospital care, including those that are uninsured. In addition, we have posted contracted rates with third party payers using one of the machine-readable file formats listed in the regulations to provide the five types of 'standard charges.'"
Spokespeople at CommonSpirit and Ascension weren't immediately available for comment.