Most hospitals 'unambiguously noncompliant' with price transparency rules, study finds

In a study published in the journal Health Affairs, analysts from The Hilltop Institute collected the price transparency files for the largest 100 hospitals in the U.S. by certified bed count from late January 2021 to early February 2021. (Getty/utah778)

If one were grading hospitals on how well they're complying with federal price transparency rules, most would have a failing report card, a recently published study found. 

In a study published in the journal Health Affairs, analysts from The Hilltop Institute collected the price transparency files for the largest 100 hospitals in the U.S. by certified bed count from late January 2021 to early February 2021.

The Hilltop Institute is a nonpartisan research organization at the University of Maryland.

The goal, wrote Hilltop's Morgan Henderson and Morgane Mouslim, was to determine how well the hospitals were complying with the regulation.

"Of the 100 hospitals in our sample, 65 were unambiguously noncompliant," Henderson and Mouslim wrote.  

RELATED: Analysis: Roughly 2,000 hospitals fully compliant with new price transparency rule

For instance, they said, 18% of the hospitals did not post any files or provide links to searchable databases that were not downloadable.

A whopping 82% of the hospitals either did not include the payer-specific negotiated rates with the name of payer and plan clearly associated with the charges or were in some other way noncompliant.

The report acknowledges the challenges posed by the COVID-19 pandemic and concerns raised by the hospital industry about the price transparency requirements. Hospitals have called on the Department of Health and Human Services to "exercise enforcement discretion" until the end of the public health emergency. 

But the authors of the report said they were still "troubled" by the findings from some of the largest hospitals in the U.S., particularly as they said their findings were most certainly an underestimate.

"We strongly believe that hospitals should be required to adhere to this regulation," they wrote. "As the final rule notes at several points, hospitals already have all of this information in their electronic medical record and claims processing systems; while assembling and posting these required files entails some costs, it should not be insurmountable."

As well, they said, hospitals were already granted a one-year extension to comply with the regulation. In fact, the authors found, 22 hospitals "managed to clearly comply, suggesting that industrywide, structural barriers are not preventing hospitals from posting their standard charges."

They said they plan to continue monitoring hospital websites and publishing compliance updates.

"We urge CMS to actively monitor compliance and to use their considerable leverage to incentivize hospitals to comply," they wrote.