Only 36% of reviewed hospitals fully compliant with federally-mandated price transparency rule

WASHINGTON, July 20, 2023 /PRNewswire/ -- Today, PatientRightsAdvocate.org (PRA) released a new report finding that most hospitals continue to hide upfront prices, despite the Hospital Price Transparency Rule that went into effect two and a half years ago. 

PRA's fifth Semi-Annual Hospital Price Transparency Compliance Report found that only 36% of the 2,000 hospitals reviewed were fully complying with the Hospital Price Transparency Rule. These findings mark a slight improvement in compliance from the report released in February showing just 24.5% compliance.

For the first time, PRA has compiled and made public the standard charges files for all 2,000 hospitals reviewed for the latest report, to enable easy access and comparison by consumers, purchasers, technology developers, and other interested parties.

"Unfortunately, our findings show that the majority of hospitals across the country are still failing to comply with the Hospital Price Transparency Rule," said Cynthia Fisher, Founder and Chairman of PatientsRightsAdvocate.org. "When hospitals hide behind estimates or don't post all real prices, they are leaving consumers in the dark. Making all actual prices available upfront will empower patients, employers, and unions to choose the best care at prices they know they can afford, and protect all Americans from overcharges, errors, and fraud. 

"We encourage the administration to enforce the law and hold hospitals accountable for failing to comply with transparency rules," Fisher continued. "Nearly 90% of Americans agree that hospitals, providers, and health insurers should be required to post their prices online for everyone to easily access. While we are encouraged by the growing momentum behind this movement, now is the time for Congress to stand up for all healthcare consumers by passing legislation to codify, strengthen, and enforce the price transparency rules to create a more affordable, competitive healthcare system for everyone."  

The new analysis of 2,000 hospitals across the United States found:

• Only 721 (36%) were fully complying with the rule.
• 1,279 hospitals (64%) were not in full compliance with the rule.
• 69 hospitals did not post any usable standard charges file and were in total noncompliance.
• Although 1,228 (61.4%) of hospitals posted negotiated prices clearly associated with payers and plans, 507 of the 1,228 (41.3%) were deemed non-compliant due to missing or incomplete pricing data.
• Compliance varied widely among the largest hospital systems reviewed.
• The nation's largest hospital system, HCA Healthcare, did not have a single fully compliant hospital, with a significant amount of its hospitals posting illegible, nonconforming files.
• None of the hospitals owned by HCA Healthcare, Tenet Healthcare, Providence, Avera Health, UPMC, Baylor Scott & White Health, or Mercy were found to be compliant.
• Significantly improving since our last report, 88% of hospitals owned by CommonSpirit Health, 97% of hospitals owned by Community Health Systems, and 98% of hospitals owned by Kaiser Permanente were found to be in compliance.
• 40 hospitals exhibited 'backsliding,' with an assessment of Noncompliant in the current report after having been assessed as Compliant in our prior report.
• A significant number of hospitals posted encoded, complex JSON-formatted files without user documentation, or complicated formats making them unusable in some cases.

You can view the full PatientRightsAdvocate.org price transparency compliance report here. 

PatientRightsAdvocate.org is a nonprofit organization fighting for systemwide healthcare price transparency. We seek to empower patients and consumers with actual, upfront prices, greatly reducing healthcare costs through a functional, competitive market.

SOURCE Patient Rights Advocate