The American Hospital Association (AHA) says that the latest hospital price transparency report is intentionally misleading.
According to the AHA, the report "blatantly misconstrues, ignores, and mischaracterizes hospitals' compliance with federal price transparency regulations."
Of the 2,000 hospitals reviewed in the report, Patient Rights Advocate found that only 36% were complying with the price transparency rule, leaving 64% of hospitals in noncompliance. The report also says that 61.4% of hospitals posted negotiated prices clearly associated with payers and plans, but 41.3% still failed compliance because their pricing data was missing or significantly incomplete.
The Patient Rights Advocate report even called out seven large health systems in the report that it said were completely noncompliant with the law.
The AHA pushed back on this data by pointing to a recent report by CMS that found that as of 2022, 70% of hospitals had complied with both federal requirements and over 80% had complied with at least one.
Inconsistent data in price transparency reports isn’t new.
In fact, HealthLeaders previously touched base with Chris Severn, CEO of Turquoise Health, to help give context to these studies and why revenue cycle leaders are seeing such varied numbers in price transparency adherence.
HealthLeaders: Price transparency studies are being published left and right, but why are we seeing such large variances in these numbers across the board?
Chris Severn: At a high level, in the CMS mandate, hospitals must follow strict guidelines to be fully compliant. The placement of the patient estimate tool on the hospital’s website, the naming convention of machine-readable files, and the use of plain language (language that patients can easily understand) to describe a healthcare service are all defined and required within the rule.
Because of the vast array of guidelines included in the rule, it’s not uncommon to see findings that are focused on all price transparency requirements. On the other hand, other studies lean more on the contents of the machine-readable files and less or not at all on the patient estimate tool. That variance in the specific areas of focus leads to different estimates of adherence based on differing factors.
Amanda Norris is the Associate Content Manager of Finance, Payer, Revenue Cycle, and Strategy for HealthLeaders.
The AHA says a recent price transparency report "blatantly misconstrues, ignores, and mischaracterizes hospitals' compliance with federal price transparency regulations."
But, inconsistent data in price transparency reports isn’t new and will probably be an ongoing battle.