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Only 16% of Hospitals Complying with Price Transparency Rule

Analysis  |  By Jay Asser  
   August 17, 2022

Nearly 20 months after the mandate went into effect, hospitals continue to be noncompliant with providing clear pricing for patients.

Hospitals have made little progress on complying with the price transparency rule as compliance rates remain low, according to a report by PatientRightsAdvocate.org.

The latest Semi-Annual Hospital Price Transparency Compliance Report reveals that just 16% of hospitals are adhering to the necessary requirements for providing pricing data for patients, nearly 20 months after the law went into effect on January 1, 2021.

The rule requires hospitals to post pricing information online through a comprehensive machine-readable file with all items and services they provide, as well as through a display of shoppable services in a consumer-friendly format.

Findings in the Compliance Report, which reviewed 2,000 hospitals, show there hasn't been much headway made on getting facilities to follow the mandate. Along with 16% of hospitals being noncompliant, the latest report uncovered that 5.1% did not post any standard charges at all. In the two previous reports released by PatientsRightsAdvocate.org, hospitals complied at a rate of 14.6% one year after the rule in February 2022, and at a rate of 5.6% six months after the rule in July 2021.

"It's alarming to see that progress on compliance with federal law on transparency has ground nearly to a stop," said Cynthia Fisher, founder and chairperson of PatientsRightsAdvocate.org.

Related: Competition Correlates with Hospital Price Transparency Compliance

The latest report also found that two of the largest health systems in the nation, HCA Healthcare and Ascension Health, are the worst perpetrators of the rule as none of their hospitals are compliant.

Meanwhile, another one of the biggest health systems, CommonSpirit Health, now features a compliance rate of 40.5%, which is up from just one of 88 hospitals being compliant in the February report.

Despite the low compliance rates, only two hospitals have been penalized to date—Northside Hospital Atlanta to the tune of a $883,180 fine, and Northside Hospital Cherokee, which received a $214,320 fine. The report highlights that after the two hospitals were issued the fines on June 7 of this year, they both updated their standard charges files and came into full compliance by July 1.

Fisher believes the quickest way to get hospitals on board with the rule is with stronger enforcement.

"With enforcement, fines, and transparent hospital accountability we will see the power shift to healthcare consumers and employers to lower costs," Fisher said. In this report we have outlined more than 100 hospitals that HHS could fine today based on criteria applied to the two hospitals they've previously fined. That is a great place to start."

Related: Price Transparency Rule is a Burden for Hospitals

Jay Asser is the contributing editor for strategy at HealthLeaders. 


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