The majority of American hospitals are still not transparent on their pricing of hospital procedures, even though transparency policies were initiated in 2019, according to recent studies on hospital pricing for joint replacements and other procedures.
Under the Centers for Medicare and Medicaid Services (CMS) hospital price transparency rule, all hospitals must provide a list of standard charges for all services and items online in a downloadable format.
For each operation, pricing, gross charges, payer-specific charges, minimum, maximum, and discounted cash prices must all be made public.
Additionally, each item or price must be identifiable by any code used by the hospital for billing, and the information must be available free of charge without requiring personal information to access.
However, the Cleveland Clinic researchers found that only around a third of hospitals were compliant with transparent pricing, with only around 23 percent of hospitals allowing customers to easily search up the procedures through their codes.
One-fifth of hospitals asked for personal information to give pricing estimates and 17 percent of hospital websites took researchers more than 15 minutes to find the prices. These all demonstrated delayed compliance to pricing transparency policies.
The Hospital Price Transparency rule under the CMS was introduced to reduce unnecessary spending and price transparency to improve consumer-friendliness.
The policy was first initiated under the Trump administration in 2019 and the final version came into effect in 2021 under the Biden administration.
Though the Cleveland study only assessed joint replacements, as these operations are very common with predictable costs and outcomes, they are illustrative of individual hospitals’ overall compliance.
Rice University's study further supported their finding, showing over 60 percent of highly-rated, major American hospitals were not fully transparent for three different joint replacement operations, MRI, ultrasound, and chest x-rays.