Seven of the 19 Commonwealth facilities surveyed did not have information on discounted cash prices.
Hospitals nationwide have been slow to get up to speed on price transparency compliance and hospital-dense Massachusetts is faring no better, according to a new report by Pioneer Institute.
The survey analyzes 19 facilities on 35 of the 70 shoppable services required by CMS as part of the price transparency law, which took effect on January 1, 2021.
Researchers found that that compliance rates ranged from 60% at Emerson Hospital to 97% at Mass General, while seven hospitals had no information on discounted cash prices — the price for self-pay patients.
Those seven hospitals were Boston Children's, Falmouth, Holyoke Medical Center, MetroWest Medical Center, Mount Auburn, New England Baptist and St. Vincent's.
"Our earlier work found disappointing compliance with Massachusetts' 2012 healthcare price transparency law," said Pioneer executive director Jim Stergios. "And now we find that compliance with the federal law isn't much better. We are not insensitive to the challenges providers are facing, but it is disappointing that compliance with the law has not budged much since 2017, when Pioneer began monitoring hospital price transparency efforts."
The 12 hospitals that did provide some discounted cash prices had pricing discrepancies. For example, the survey highlighted that an MRI of a leg joint was more than $3,400 at Mass General and Brigham and Women's, but $775 at Carney 10 miles away.
"The disparities we observe strongly suggest a market dominated by the systems that are able to maintain prices above competitive norms," said report author Barbara Anthony. "This is why it's crucial that consumers, employers, benefit managers and insurers have ready access to provider prices."
Where the surveyed hospitals did relatively well in was providing prices in machine-readable formats (MRF), which not necessarily for the benefit of consumers due to its lack of user-friendly readability. Only two of the 19 hospitals had no MRF data.
To improve price transparency compliance, the authors of the survey offer recommendations, including: hospitals appoint a single administrator to be in charge of adherence, the federal government provide guidance to hospitals on how to make pricing information more consumer-friendly, CMS enforce the law more strongly, and the Massachusetts state government come up with incentives for hospitals to comply.
After hospitals got off to a slow start with compliance, an October report by Turquoise Health revealed that 76% of facilities have posted a MRF, 65% have posted an MRF with negotiated rates, and 63% have posted an MRF with cash rates.
Nonetheless, the Office of Inspector General recently said it will be keeping an eye on CMS' enforcement of the law after the agency resisted on issuing fines for violations until June.
Jay Asser is the contributing editor for strategy at HealthLeaders.
KEY TAKEAWAYS
Pioneer Institute took a look at 19 Massachusetts hospitals to check on the pricing information they've made available.
Compliance ranged from 60% to 97%, while seven hospitals had no information on discounted cash prices.
All but two hospitals provided prices in machine-readable files, though that data isn't consumer-friendly.