Over- and underreporting of prices: most hospitals are not compliant with the Hospital Price Transparency Rule

Concern has been raised about the effectiveness of the Hospital Price Transparency Rule to facilitate a clear understanding of health care prices due to poor reporting by hospitals. However, the relationship between what services the hospital provides and what prices they report is not clear. We assessed reported prices in the Turquoise Health database and compared them at the hospital level with the CMS Provider of Services File to identify if a shoppable service was provided at a hospital. We found significant mismatch between the hospital prices being reported and the services being provided. For example, 56% of hospitals providing at least 1 shoppable service that requires public price reporting did not report any prices. Of hospitals reporting prices, most hospitals (66%) reported prices for only a portion of the services they provide. In addition, 12% of hospitals reported prices for services they do not provide. Only 6% of hospitals had complete concordance with price reporting and services they actually provide. Current compliance enforcement and penalties do not appear to be adequate to achieve the goals of the Hospital Price Transparency Rule.

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Publication Details

Journal
Health Affairs Scholar
Published
2024-08-15
DOI
https://doi.org/10.1093/haschl/qxae099
Citations
2
Primary Topic
Healthcare Policy and Management
Type
article
Field-Weighted Citation Impact
2.26

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article

Over- and underreporting of prices: most hospitals are not compliant with the Hospital Price Transparency Rule

Mitchell Mead, Andrew M. Ibrahim
2 citations
Health Affairs Scholar
Healthcare Policy and Management
2.26
article

Over- and underreporting of prices: most hospitals are not compliant with the Hospital Price Transparency Rule

Mitchell Mead, Andrew M. Ibrahim
article en
2 citations

Abstract

Concern has been raised about the effectiveness of the Hospital Price Transparency Rule to facilitate a clear understanding of health care prices due to poor reporting by hospitals. However, the relationship between what services the hospital provides and what prices they report is not clear. We assessed reported prices in the Turquoise Health database and compared them at the hospital level with the CMS Provider of Services File to identify if a shoppable service was provided at a hospital. We found significant mismatch between the hospital prices being reported and the services being provided. For example, 56% of hospitals providing at least 1 shoppable service that requires public price reporting did not report any prices. Of hospitals reporting prices, most hospitals (66%) reported prices for only a portion of the services they provide. In addition, 12% of hospitals reported prices for services they do not provide. Only 6% of hospitals had complete concordance with price reporting and services they actually provide. Current compliance enforcement and penalties do not appear to be adequate to achieve the goals of the Hospital Price Transparency Rule.

Health Affairs ScholarVol. 2(9)
University of Michigan (US), A. Alfred Taubman Health Care Center (US)
Center for Health Design
No poverty
Openalex Percentile: Top 8%
Healthcare Policy and Management
2.26
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Over- and underreporting of prices: most hospitals are not compliant with the Hospital Price Transparency Rule — Mitchell Mead, Andrew M. Ibrahim · Health Affairs Scholar (2024) | TGRS Research Map | TGRS