Provision of Hospital Price Information After Increases in Financial Penalties for Failure to Comply With a US Federal Hospital Price Transparency Rule

Kong, Edward; Ji, Yunan

doi:10.1001/jamanetworkopen.2023.20694

Cited by 6 publications

(3 citation statements)

References 14 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study is limited by constraints of the Turquoise Health dataset, which is updated weekly but may lag behind actual pricing disclosure on hospital websites. Although other authors have analyzed the prevalence of hospital price disclosure after the CMS Final Rule went into effect, 3,7–9 these only included acute care hospitals and only looked at price disclosure at one or two points in time. To our knowledge, this study is the first to provide granular data on the incidence of price disclosures over time and to include all US hospitals.…”

Section: Discussionmentioning

confidence: 99%

Trends in hospital price transparency after implementation of the CMS Final Rule

Brant,

Lewicki,

Rhodes

et al. 2024

Health Services Research

View full text Add to dashboard Cite

ObjectiveTo assess trends in hospital price disclosures after the Centers for Medicare & Medicaid Services (CMS) Final Rule went into effect.Data Sources and Study SettingThe Turquoise Health Price Transparency Dataset was used to identify all US hospitals that publicly displayed pricing from 2021 to 2023.Study DesignPrice‐disclosing versus nondisclosing hospitals were compared using Pearson's Chi‐squared and Wilcoxon rank sum tests. Bayesian structural time‐series modeling was used to determine if enforcement of increased penalties for nondisclosure was associated with a change in the trend of hospital disclosures.Data Collection/Extraction MethodsNot applicable.Principal FindingsAs of January 2023, 5162 of 6692 (77.1%) US hospitals disclosed pricing of their services, with the majority (2794 of 5162 [54.1%]) reporting their pricing within the first 6 months of the final rule going into effect in January 2021. An increase in hospital disclosures was observed after penalties for nondisclosure were enforced in January 2022 (relative effect size 20%, p = 0.002). Compared with nondisclosing hospitals, disclosing hospitals had higher annual revenue, bed number, and were more likely to be have nonprofit ownership, academic affiliation, provide emergency services, and be in highly concentrated markets (p < 0.001).ConclusionsHospital pricing disclosures are continuously in flux and influenced by regulatory and market factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Trends in hospital price transparency after implementation of the CMS Final Rule

Brant,

Lewicki,

Rhodes

et al. 2024

Health Services Research

View full text Add to dashboard Cite

show abstract

“…The cost of compliance, requiring adequate information technology expertise and personnel, can be a barrier to hospitals with fewer financial resources [ 8 ]. Strategies to increase compliance include implementing positive incentives, proper enforcement, and increased financial penalties [ 9 ]. Many MMS procedures are performed in private clinics, which the Price Transparency Rule does not apply to.…”

Section: Discussionmentioning

confidence: 99%

Mohs Surgery Price Transparency and Variability at Academic Hospitals After the Implementation of the Federal Price Transparency Final Rule

Jain,

Gronbeck,

Beltrami

et al. 2023

JMIR Dermatol

View full text Add to dashboard Cite

“…To its credit, in response to these data, CMS has made efforts to improve the value of pricing information through stakeholders listening sessions, standardize reporting, simplified public access to data, and streamlined enforcement mechanisms . The latter initiative is supported by evidence that financial penalties (and the 2022 increase in these penalties) improve compliance . The sooner that a posted price quote for a specific service could evolve into an “out the door” price guarantee—as found in other industries—the better for consumers interested in shopping for care.…”

mentioning

confidence: 99%

Health Care Transparency—What You See Should Be What You Get

Parzuchowski,

Fendrick

2023

JAMA Intern Med

View full text Add to dashboard Cite

The rapid increase in out-of-pocket medical costs has motivated the implementation of policies that provide consumerfriendly and actionable cost information. The aims of price transparency regulations include a more engaged health care consumer and enhanced competition among clinicians, ultimately leading to improved patient-centered outcomes and increased efficiency in medical spending. An important example is the Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule that requires hospitals to disclose cash prices and commercial payerspecific negotiated rates for 70 clinical services deemed to be shoppable. 1 While there is broad multistakeholder support behind price transparency efforts, programs designed to achieve these ambitious goals have proved challenging to implement, and evaluations have reported mixed results. Concerns include that the information provided to consumers often lack context (eg, absence of information regarding patient out-of-pocket cost), that posted data are often incomprehensible to allow informed medical decisions, and that patients are charged for services not included in the quoted price. 2 Despite these limitations, decision-making based on the posted cost information for shoppable services should be relatively straightforward, especially for the nearly one-third of people in the US who are uninsured or enrolled in high-deductible health plans, since the posted price is the one that the patient would be responsible to pay.In this issue of JAMA Internal Medicine, Thomas and colleagues 3 shine more light on the challenges and shortcomings of existing hospital pricing reporting requirements, demonstrating that in many circumstances the information available to consumers requesting a cash price for shoppable services can be unavailable, often misleading, and frequently unhelpful. In this cross-sectional study, the researchers used secret shoppers to determine and compare a hospital's online cash price (when accessible) for vaginal childbirth and brain magnetic resonance imaging-2 of the required CMS shoppable services-with cash prices offered over the telephone (when accessible). Three hospital categories were sampled: 20 top-ranked, 20 safety-net, and 20 non-topranked, non-safety-net. The study's results affirm concerns regarding the usefulness of current transparency efforts in that less than half of the hospitals provided online prices and that when prices were made available both online and over the phone, there was poor correlation between the online and phone prices. The latter finding suggests that a patient may often end up paying an amount different than quoted online.

show abstract

Provision of Hospital Price Information After Increases in Financial Penalties for Failure to Comply With a US Federal Hospital Price Transparency Rule

Cited by 6 publications

References 14 publications

Trends in hospital price transparency after implementation of the CMS Final Rule

Trends in hospital price transparency after implementation of the CMS Final Rule

Mohs Surgery Price Transparency and Variability at Academic Hospitals After the Implementation of the Federal Price Transparency Final Rule

Health Care Transparency—What You See Should Be What You Get

Contact Info

Product

Resources

About