Feb 6, 2023 - Health

A quarter of hospitals in full compliance with transparency rule

Illustration of a health plus-shaped price tag with dollar signs printed on it.

Illustration: Gabriella Turrisi/Axios

Only a quarter of hospitals studied were fully compliant with a federal price transparency rule, according to a new report by Patient Rights Advocate — but compliance is a spectrum.

Why it matters: The findings come as Congress has expressed bipartisan concern over compliance with the Trump administration rule and potential interest in legislating on the topic.

By the numbers: Only 24.5% of the 2,000 hospitals studied were in full compliance with the rule, per the report. But there were instances of outright noncompliance and partial compliance.

  • 5.8% of hospitals were in total noncompliance.
  • Just over half of the hospitals posted negotiated prices clearly associated with payers and plans, while the other half failed to meet the study's definition of compliance because the majority of pricing data was missing or incomplete.

Zoom in: None of the hospitals owned by HCA Healthcare, Tenet Healthcare, Christus Health, Providence, Bon Secours Mercy Health, UPMC, Mercy Health, UnityPoint Health, and Avera Health were deemed compliant by the report.

Our thought bubble: The fact that there's a spectrum of compliance with the rule — and most hospitals are in at least partial compliance with it — may help explain why different studies can find such different rates.

  • For example, Turquoise Health has found that 65% of hospitals have published "robust" negotiated rates.

The other side: The American Hospital Association has also argued that compliance is much higher than some reports have suggested, including an earlier version by Patient Rights Advocate.

What they're saying: The group has outlined ways that Congress can improve the rule in a letter sent to leadership today. A separate letter to President Biden asks for stronger enforcement.

  • "We encourage you to consider legislation that boosts enforcement, increases penalties for noncompliance, establishes clear price disclosure standards, requires actual prices, not estimates, and demands hospital attestations to the quality and completeness of their data," writes founder and chairman Cynthia Fisher.
Go deeper