New Report Shows Just 14.3% of Hospitals Complying with Hospital Price Transparency Rule

The semi-annual report issued by PatientRightsAdvocate.org is a detailed look at hospital compliance with price transparency requirements required by law

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Patient Rights Advocate

Feb 10, 2022, 09:00 ET

WASHINGTON, Feb. 10, 2022 /PRNewswire/ -- A new report released by PatientRightsAdvocate.org shows that one year after a law requiring hospitals to post their real prices online went into effect, a large majority of hospitals continue to hide the cost of care from consumers.

The Semi-Annual Hospital Price Transparency Compliance Report showed that just 14.3% of the 1,000 randomly sampled hospitals are complying with a rule that went into effect Jan. 1, 2021 and was re-enforced by the Biden Administration via Executive Order in July 2021.

The report found most of the hospitals' pricing files incomplete. Noncompliant hospitals failed to show the different prices for the same services by all insurers and plans accepted as well as cash prices.

According to the report, only two of the 361 hospitals owned by three of the largest hospital systems (HCA Healthcare, Ascension, and CommonSpirit Health) were compliant with the rule. Strikingly, for HCA Healthcare, the largest for-profit hospital system in the country, none of its 188 hospitals were complying. In 2021, these three hospital systems' combined total revenue approached $120 billion making their noncompliance more egregious given the estimated cost of compliance calculated in the rule is only $12,000 per hospital.

"Unfortunately, the vast majority of hospitals remain noncompliant after more than a year has passed since the Hospital Price Transparency rule took effect," said Cynthia Fisher, Founder and Chairman of PatientsRightsAdvocate.org. "Hospitals' omission of comparative price information in advance of care blocks consumers from benefiting from knowing the competition, seeking fair and equitable prices, and having the choice to lower their costs."

The new report follows PatientRightsAdvocate.org's first Semi-Annual Hospital Price Transparency Compliance Report released last July which found that of 500 hospitals sampled, only 5.6% were compliant.

PatientRightsAdvocate.org's new analysis of 1,000 randomly selected hospitals found:

Only 14.3% were complying with the transparency rule.
Only 37.9% of the hospitals posted a sufficient amount of negotiated rates, but over half were not compliant in other criteria of the rule, such as listing rates by each insurer and named plan.
Only 0.5% of hospitals owned by the three largest hospital systems in the country – HCA Healthcare, Ascension, and CommonSpirit Health – are complying.

"The Biden Administration has been a huge supporter of competition and transparency in healthcare," said Fisher. "The law unleashes the pricing data which is the foundation of creating a functional, competitive market. We're confident they will deliver for the American people, holding hospitals and insurance companies accountable by increasing penalties and enforcement and refusing any additional delays to the Transparency in Coverage Rule."

The Transparency in Coverage Rule, which will become law in July 2022, will require group health plans and health insurance issuers to publicly disclose negotiated prices for all covered items and services and historical payments, and disclose cost-sharing information upon request to a participant, beneficiary, or enrollee. The Transparency in Coverage Rule was originally scheduled to go into effect on Jan. 1, 2022 but was delayed after intense lobbying by the insurance industry.

You can view the full PatientRightsAdvocate.org transparency report here.

SOURCE Patient Rights Advocate