Report: Only 5% Of Hospitals Fully Compliant With Controversial Price Transparency Rule

July 20, 2021

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Source: Fierce Healthcare, by Robert King

A new analysis found only 5.6% of hospitals were fully compliant with a major price transparency rule, with most failures centered on not posting payer-negotiated prices.

The analysis released Friday by the group PatientRightsAdvocate.org is the latest evidence of widespread noncompliance with the rule, which went into effect back in January.

“These findings align with previous research indicating that hospitals are undermining the rule with incomplete information, burdensome access restrictions, code to block prices from being displayed on search engines and tools to obfuscate access to mobile app developers and to patients,” the analysis said.

Another problem has been price estimator tools that don’t enable meaningful accessible comparison of discounted cash prices, researchers said.

The group examined a random sample of 500 hospital websites out of the roughly 6,000 facilities subjected to the rule’s requirements.

Only 5.6% of the websites were compliant with all the rule’s requirements. It found that 471 facilities did not post a complete machine-readable file of standard charges.

A large majority (80.6%) of hospitals did not publish payer-specific negotiated charges that were clearly associated with each payer and plan, a controversial requirement of the rule. It found that 258 hospitals (51.6%) didn’t publish any negotiated rates at all and 198 hospitals (39.6%) didn’t publish any discounted cash prices.

The rule required hospitals to also publish 300 shoppable healthcare services in a list or an estimator tool. The group found that 96 hospitals presented them in a “consumer-friendly display for customary charges. However, a significant number of these hospitals presented incomplete data fields and were therefore noncompliant.

There were 378 hospitals that posted a price estimator tool. However, the tools were inconsistent and limited researchers’ ability to determine if the tool was compliant with the rule.

The analysis is the latest finding that many hospitals are not complying with the new rule. A study published last month found that 83 out of 100 randomly sampled hospitals were not compliant with the regulation.

The Centers for Medicare & Medicaid Services has sent out warnings to some hospitals for noncompliance. There is a $300-per-day penalty for hospitals for each day they aren’t fully following the regulation.

But the analysis posits that the penalty is nowhere near enough.

“Scaling the penalty to $300 per hospital per bed per day and robustly enforcing the rule will result in a meaningful financial incentive for hospitals to comply, while providing proportional fairness to smaller and rural hospitals,” the group said.

PatientRightsAdvocate.org also wants CMS to scrap the requirement for a price estimator tool and instead require hospitals to provide “guaranteed price quotes.”

 

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