National study of hospitals finds low adherence to the federal price transparency mandate

In January 2021, the Centers for Medicare and Medicaid Services (CMS) passed a federal law that requires hospitals to make the costs of standard healthcare services transparent. Investigators at the Brigham systematically analyzed a nationally representative sample of all Medicare-registered acute-care hospitals across the U.S. for compliance with this law. Two independent reviewers evaluated whether each hospital adhered to the 21-point CMS hospital price transparency checklist and compared non-teaching vs. teaching hospitals, non-profit vs. for-profit hospitals, and hospitals in regions with different levels of regional market competition.

Researchers found that only 1 in 5, or 19 percent, of hospitals were fully adherent to the entire checklist. Teaching and non-profit hospitals were slightly more compliant than non-teaching or for-profit hospitals. Further, only 8 percent of hospitals in competitive markets, where patients may benefit the most from being able to compare prices, were compliant, compared to 33 percent in non-competitive markets. Findings suggest nationwide, patients are often unable to access information about hospital charges for basic services.

"The transparency mandate ensures patients can estimate how much their medical care might cost and shop around amongst competing hospitals to find the best price," said senior author Haider J. Warraich, MD, of BWH's Division of Cardiovascular Medicine. "However, our analysis found low compliance with the mandate. More efforts are needed to improve the state of healthcare financial toxicity in the country."

The work is published in the Journal of General Internal Medicine.