News: Smaller hospitals less likely to meet CMS’ price transparency requirements, study says

A correlation was found between hospitals with fewer beds and lack of adherence to CMS’ price transparency mandate requirements, according to a new study published in ClinicoEconomics and Outcomes Research.

In general, hospitals have struggled to meet the mandate, which “requires hospitals to disclose gross charges online through a comprehensive machine-readable file with all items and services they provide, as well as through a display of shoppable services in a consumer-friendly format,” since it went into effect on January 1, 2021, HealthLeaders reported. The price transparency compliance ranged from 13% to 49% of hospitals overall, though the study found 62% of hospitals reported prices for at least one of the 14 billable healthcare services.

Researchers identified characteristics of 6,214 hospitals, noting a lower rate of price transparency in hospitals with fewer beds as well as those in the southern and western regions of the United States. They noted in the study that it’s unclear whether the smaller hospitals’ lack of adherence is due to a lack of resources or a reduced penalty for noncompliance that CMS allows based on hospital bed count. The lack based on region, however, they said could be attributed to less hospitals in their area to compete with for patients.

“The findings of this study shine light on the poor state of price transparency for healthcare services throughout various specialties in hospitals across the US and elucidate pertinent relationships between hospital characteristics and price transparency,” the researchers stated.

These findings run counter to other recent studies that showed hospitals in less competitive markets and those with greater market shares have higher price transparency compliance rates. But complying with pricing requirements does not necessarily mean hospitals do so in a patient-friendly manner. The researchers called obtaining list prices from hospital chargemasters a tedious task involving many steps, so even if a hospital is being transparent with its pricing patients may struggle to find the prices anyway.

“Thus, the current CMS legislation’s efforts at price transparency fall short of its aim to provide patients with the necessary information to make informed care decisions,” the researchers said.

Editor’s note: To read HealthLeaders’ coverage of this story, click here. To read the study, click here.