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30% of hospitals are noncompliant with CMS price transparency rule

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February 18, 2021

By Alexandra Wilson Pecci, HealthLeaders Media

Roughly 30% of hospitals aren't compliant with either requirement of the CMS price transparency rule, according to an analysis of more than 1,000 hospitals across 27 states by the consulting services firm Guidehouse.  

Unsurprisingly, more hospitals were compliant with the 300 consumer-friendly shoppable services portion of the rule than the machine-readable file portion, with 60% of hospitals complying with the shoppable services requirement.

Comparatively, only 48% of hospitals were compliant with the machine-readable file requirement, and even that percentage might be generous.

According to the CMS rule, the machine-readable file must include five standard charges. Guidehouse "scanned for each of the five standard charges to be present in at least one of the files…and if the file was present and the provider had all or some form of the standard charges, they were deemed to be compliant."

In addition to revealing compliance rates, the Guidehouse analysis also found that:

  • Noncompliant hospitals are either significantly under resourced, don't fully understand the rule, and/or are taking a wait-and-see approach based on what their competitors do.
     
  • Larger hospitals and health systems were most likely to be compliant and are often using existing tools to comply with the shoppable services portion of the rule.
     
  • The machine-readable files that do exist are inconsistent in terms of format and content. Therefore, those files are hard to use "without significant data transformation and enhancements."

These findings are consistent with what Becky Greenfield, partner with the Miami law firm Wolfe Pincavage, told HealthLeaders in January about early compliance with the rule. As of January 7, none of the hospitals she had investigated in an informal audit were fully compliant with the rule.

Alexandra Wilson Pecci is an editor for HealthLeaders. This article originally ran on HealthLeaders. 




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