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New Price Transparency Report Shines Light on Growing Adoption of the Regulation

Analysis  |  By Amanda Norris  
   October 19, 2022

A new report outlines the healthcare industry's progress to date on price transparency compliance.

A recent price transparency impact report, conducted by Turquoise Health, highlights a positive trend in adherence to the regulation.

According to the report, 76% of hospitals have posted a machine-readable file (MRF), 65% have posted an MRF with negotiated rates, and 63% have posted an MRF with cash rates.

Major health systems such as the Mayo Clinic, Advocate Aurora Health, and Prime Healthcare, have posted 5-star MRFs, the highest possible score, according to the Turquoise Health price transparency scorecard.

On the payer data side, 80 carriers have published rates. This includes BlueCross BlueShield, United, Cigna, Aetna, and Humana, the report said.

"We expect the initial phase of price transparency adoption to take five years," says Turquoise Health CEO, Chris Severn.

The clock started in January of 2021 when the first of three different rules and laws that dictate price transparency went into effect. The price transparency rule requires health systems to publicly post the costs of their items and services online.

The posted prices must include standard charges for all items and services for all payers and health plans and a standard charges list or a price estimator tool for the 300 most common services.

Adherence to the regulation has been off to a slow start as many organizations site administrative burdens and revenue cycle workforce shortages as the cause to slow adoption.

It seems though, that organizations are finally catching up.

"After seven quarters of transparency, progress is evident. 65% of hospitals have published robust negotiated rates. Additionally, 80 carriers have also published rates, representing over the majority covered lives in the United States," Severn said in a press release.

This newest report shows a step in the right direction as many recent studies have shed light on the large lack of adherence.

For example, as recently as August, the Semi-Annual Hospital Price Transparency Compliance Report found that hospitals as a whole had made little progress on complying with the price transparency rule. At that time, the report revealed that just 16% of hospitals were adhering to all necessary requirements for providing pricing data for patients.

Revenue cycle leaders should ensure their organizations are in compliance with all provisions of the hospital price transparency final rule. Adding price transparency to internal audit plans and making sure public-facing price information is current will help your departments and organization avoid repercussions.

 

Amanda Norris is the Associate Content Manager of Finance, Payer, Revenue Cycle, and Strategy for HealthLeaders.


KEY TAKEAWAYS

Adherence to the price transparency regulation has been off to a slow start, but it seems health systems may finally be catching up.

According to the data, 65% of hospitals have published robust negotiated rates.


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