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The latest Hospital Price Transparency Compliance Report, released in February 2024, sheds light on the progress and challenges in achieving meaningful price transparency in the healthcare industry. This report, compiled by PatientRightsAdvocate.org, analyzed the websites of 2,000 U.S. hospitals to assess their compliance with the federal Hospital Price Transparency Rule. Download the full report here.
1. Compliance Rates Remain Low: Only 34.5% of the hospitals reviewed were found to be fully compliant with all the requirements of the price transparency rule. The remaining 65.5% were deemed noncompliant due to missing or incomplete pricing data.
2. Inconsistent Reporting: The report found significant variation in compliance among the nation's largest hospital systems. While some systems, like Community Health Systems and Christus Health, had high compliance rates, others, such as HCA Healthcare, Tenet Healthcare, and Kaiser Permanente, had no fully compliant hospitals.
3. Barriers to Usability: Many hospitals posted pricing data in formats that were difficult for consumers and technology developers to navigate, such as unnecessarily large "tall" files and complex JSON-formatted files without user documentation.
4. Lack of Enforcement: The report highlights the need for more thorough and timely enforcement of the price transparency rule by the Centers for Medicare and Medicaid Services (CMS). To date, CMS has issued penalty notices to only 14 out of the approximately 1,800 hospitals it has identified as noncompliant.
1. Strengthen Enforcement: The report calls for CMS to enforce the price transparency rule more quickly and thoroughly, publicly post the entire compliance process, and utilize payers' Transparency in Coverage data to verify the accuracy and completeness of hospitals' price files.
2. Eliminate Price Estimates: The report suggests that CMS should require hospitals to provide actual, binding prices for each payer and plan, as well as discounted cash prices, rather than relying on non-binding price estimates.
3. Standardize Pricing Data: The report recommends that CMS set additional requirements for the "tall" file format, including a maximum number of rows and a cap on file size, to improve the usability of the data.
4. Require Executive Attestation: The report encourages CMS to require senior hospital officials, such as the Chief Executive Officer, to attest to the accuracy and completeness of the pricing data, potentially incorporating liability under the False Claims Act.
5. Expand Transparency to All Providers: The report suggests that price transparency requirements should be expanded to all healthcare providers, including ambulatory surgical centers and accountable care organizations, to allow for more comprehensive price comparisons.
SumHealth offers a dynamic price transparency solution, swiftly tailored to meet the unique needs of any hospital. This adaptable solution ensures a rapid and efficient customization process, allowing hospitals to seamlessly integrate comprehensive transparency features designed specifically for their individual requirements.
To learn more about how SumHealth can help your hospital navigate price transparency compliance, contact us at contact@sumhealth.org or schedule a demo here.
