Report: Only quarter of hospitals analyzed complied with key price transparency rule

A new analysis finds widespread compliance with a hospital price transparency rule remains elusive two years after its implementation, with roughly a quarter of hospitals meeting requirements. 

The group Patient Rights Advocate released its fourth semi-annual price transparency report on Monday detailing the results of an analysis of the websites of 2,000 U.S. hospitals. It found that only 24.5% of the hospitals fully complied with a rule to post prices for certain items and services, compared with 16.5% in the group’s last report in August 2022. 

“This blatant obfuscation of prices and flouting of the rule demonstrates that implementation and enforcement efforts must be rigorously examined and markedly strengthened to improve compliance, enable technology innovators to parse the pricing data, and empower American consumers with upfront prices,” the report said. 

The rule went into effect on Jan. 1, 2021, requiring all hospitals to post online a machine-readable standard charges file for all of its items and services for all payers. Hospitals must also display the actual prices or a price estimator tool that offers details on the charges for 300 shoppable services.

The group found that a majority of hospitals had posted files. However, the main reason for the widespread noncompliance is that such files are “incomplete, illegible or not having prices clearly associated with both payer and plan,” the analysis said. 

It found there were nearly 6% of hospitals (116) that didn’t post any standard charge files.

Compliance was mixed between different types of health systems, the study found. 

For instance, none of the hospitals owned by “HCA Healthcare, Tenet Healthcare, Christus Health, Providence, Bon Secours Mercy Health, UPMC, Mercy Health, UnityPoint Health and Avera Health were found to be compliant,” the report said. 

Most of HCA Healthcare’s hospitals posted illegible files, according to the report. However, 53% of CommonSpirit hospitals and 73% of hospitals owned by LifePoint Health complied.

Patient Rights Advocate charged that the Department of Health and Human Services must step up its enforcement of non-compliant hospitals. Since the rule went into effect, HHS has only fined two hospitals out of the thousands likely to be non-compliant, the report said.

“While those two hospitals immediately came into exemplary compliance, HHS has not issued any additional penalties,” the group added. “Meaningful price comparisons are possible only with full compliance with price disclosure rules.”

HHS’ price transparency rule generated significant pushback from the hospital industry, which had sued to try and halt the rule from taking effect. Hospitals and health systems have argued that the rule is far too expensive to implement and remains confusing several years later.

The lingering compliance problems with the hospital price transparency rule come as insurers have generally complied with a similar rule that requires them to post pricing data. However, advocates and researchers have complained to the Biden administration that the data is often unusable and hard to understand. 

A collection of researchers called for the Centers for Medicare & Medicaid Services to make technical changes to the requirements to help with the issue.