A new analysis found that roughly 2,000 hospitals out of more than 6,000 reviewed were highly transparent posting their payer-negotiated rates per a new federal rule.
The analysis released Friday from the software provider Turquoise Health, which posts payer-provided rates from hospitals. Turquoise said that it standardized 1,500 machine-readable files into its database.
“In certain geographies, price competition looks inevitable for commoditized shoppable services,” the analysis said. “Providers (be it hospitals, [ambulatory surgery centers] or medical groups offering non-facility-based services) can expect new patient volumes to come a-knockin'.”
The analysis graded the hospital compliance based on five stars relating to the price transparency rule, which required facilities on Jan. 1 to post a machine-readable file with its rates and a file with 300 shoppable services. Hospitals that offer an estimator tool that patients can use to calculate their costs can comply with that part of the rule.
Turquoise primarily focused on the machine-readable file that can be used to create “a transparent market (vs. a multi-step estimate tool that asks patients for [personal health information] and prevents comparison shopping),” the analysis said.
A hospital that got five stars posted a shoppable service tool or file and a machine-readable file with any negotiated rates, including cash and commercial plans. A hospital with four stars posted a shoppable services tool and machine-readable file that misses a key element like a code or key service. However, commercial insurance rates are present.
The analysis found that roughly 2,000 hospitals had four or five stars, out of the more than 6,000 hospital websites that were evaluated.
Another 20% of the hospitals got three stars, where they posted a shoppable service tool but multiple elements were missing like codes or key services. But the hospitals didn’t have meaningful cash or commercial rates.
Turquoise is also evaluating roughly 1,000 providers to ensure they do not comply at all with the rule.
The rule has been a source of major controversy in the hospital industry, as several groups sued to try and stop the regulation. The legal bid, however, failed last year and the rule went into effect on Jan. 1.
The Centers for Medicare & Medicaid Services told Fierce Healthcare last month that it will audit a sample of hospitals for compliance. A hospital that isn’t in compliance could be fined $300 per day until they comply with the rule.