Hospitals are not complying with price transparency rule, two studies find
June 22, 2021 / Susan Morse, Managing Editor
Recent studies published in the Journal of the American Medical Association and the American Journal of Managed Care show that most of the hospitals sampled are not complying with the January 1 mandate to post their negotiated rates with payers.
JAMA‘s report analyzed 200 samples. First they took a look at a random sample of 100 hospitals and then also analyzed the 100 hospitals with the highest grossing revenue in 2017.
Of 100 random hospitals, 83 were noncompliant with at least one major requirement, the authors of the June 14 report said. Only 33 reported payer-specific negotiated rates and 30 reported discounted cash prices in a machine readable file.
A total of 52 hospitals offered a price estimator tool for the required 300 shoppable services, of which 23 posted payer-specific negotiated rates in a machine readable file. All price estimator tools required personal health plan information while discounted cash prices did not.
Of the 100 highest revenue hospitals in the JAMA study, 75 were noncompliant with at least one requirement. Thirty five reported payer-specific negotiated rates and 40 reported discounted cash prices in a machine readable file. A total of 86 offered a price estimator tool, of which 34 posted payer-specific negotiated rates in a machine-readable file.
