Hospitals have long filed legal challenges to federal rules that require them to post prices online. Hospital pricing transparency is supported by three administrations, Obama (passing the Affordable Care Act), Trump setting the current pricing rules, and Biden supporting their enforcement.But despite the advance notice and bipartisan support for the measure, a document from PatientRightsAdvocate.org It was found that compliance rates in hospitals remained low.
The report found that only about 14.3 percent of the 1,000 hospitals reviewed complied with transparency rules. After a review of 500 random hospitals for the first report, released last July, the company found a compliance rate of 5.6 percent, a slight increase. The same 500 hospitals (minus one: West Hills Hospital in Reno, Nevada, closed) was included in the latest sampling; in this group alone, only 18% are now compliant, according to the Patient Rights Advocate.
“We’ve seen progress,” said Cynthia Fisher, the group’s founder and chairman.
But she stressed that compliance with the law remained low.
Hospitals must publish all prices online in a way that is easily accessible to consumers—for example, health systems should not make people provide personally identifiable information to obtain prices.
They should also provide a machine-readable list of standard fees for all payers and all plans, as well as discounted cash prices. The report states that hospitals need to provide standard fee lists or price estimation tools for the 300 most common purchasable services.
“It’s forcing them to compete and pull the curtains on their crazy pricing, some of which is price gouging,” Fisher said.
That’s why, she believes, hospitals have been refusing to show prices transparently.
“They don’t want to compete because they benefit from having employers and unions and all health care consumers who pay for health care … in the dark,” Fisher said.
The report estimates that about 86% of the hospitals it reviewed failed to publish complete machine-readable standard charge documentation; 85% failed to provide national drug codes and associated prices for each drug and pharmacy item offered; nearly 59% of hospitals do not publish all specific payer negotiated fees.
Additionally, PatientRightsAdvocate.org found that none of the hospitals in HCA Healthcare, the largest U.S. health system, are in full compliance with federal price transparency regulations. According to its report, CommonSpirit Health and Ascension, the second- and third-largest U.S. health systems, only 1% of hospitals have published prices.
Perhaps, predictably, health systems have largely dismissed findings in patient reports — can we say what one said as an example?
A spokesman for the American Hospital Association said only the Centers for Medicare and Medicaid Services can assess whether hospitals are complying with federal hospital pricing transparency regulations.
The Patient Rights Advocate noted in its semi-annual hospital pricing transparency report, The organization’s team of four research analysts assessed hospital websites to determine compliance, as well as an independent healthcare price data firm. Firelight Health Reviewed and verified the report.
The HCA refuted the report’s findings, saying its hospitals complied with federal price transparency regulations.
“We have been working hard over the past year to complete the implementation of these requirements,” HCA spokesman Harlow Sumerford said in an email.
But there are signs that this is still a work in progress for the hospital.
When asked about the HCA Hospitals website offering examples of pricing that complies with federal regulations, Summerford provided a link. But the hospital’s “Patient Payment Estimator” Requires the patient to enter personally identifiable information, including first and last name and insurance member ID and relationship to the policyholder (if insured), before the patient sees pricing.
Ascension also claims it is fully compliant with pricing transparency requirements,
Only CommonSpirit Health admits that some hospitals are still working on it.
“Most of the hospitals we have posted machine-readable documents with our standard charges, cash price and negotiating prices on their website,” the health system said in a statement provided by a spokesperson. “This is a complex and time-consuming process, and we hope to publish the remaining documents by April. “
Photo: James Bray, Getty Images
