Better Solutions for Healthcare

Hospitals are hiding prices from patients, advocacy report says

The hospital price transparency rule, which took effect in January 2021, requires hospitals to publish machine-readable price lists and display rates for medical services in a format that allows consumers to comparison shop. Insurers are now required to disclose rates they negotiate with providers.

In the first year after the hospital rule, studies evaluating compliance with the regulation, including one by Patient Rights Advocatefound efforts lacking. In February, the nonprofit said only 14.3% of hospitals were compliant with disclosure requirements. CMS itself said its initial analysis “strongly suggests there is sub-optimal compliance” with the rule, and the agency increased fines for non-compliant hospitals.

The flood of information from insurers released in July, 18 months after the hospital rule, gave researchers a much greater pool of data for assessing transparency efforts. Cynthia Fisher, chairman of PatientRightsAdvocate.org, called her group’s new report the “tip of the iceberg” of what publicly disclosed data files mandated by the the new regulations will reveal.

 

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