Hospitals Fall Short on Price Transparency, Drawing Criticism From Advocacy Groups
Despite federal rules aimed at empowering patients with clear medical pricing information, hospitals are still falling short in providing transparent data, according to a recent report by Patient Rights Advocate (PRA).
The report highlights widespread noncompliance with price transparency regulations implemented under the Trump administration in 2021. While all 2000 hospital websites reviewed by PRA had machine-readable files as required, only 17% of hospitals provided clear, dollars-and-cents price data that consumers could use to compare costs. Additionally, the percentage of hospitals in full compliance with federal price transparency fell from 34.5% in February 2024 to 21.1% in November 2024. The report singled out major health systems, including Ascension, AdventHealth, Kaiser Permanente, and Bon Secours Mercy, all of which had 0 fully compliant hospitals.
The transparency rules mandate that hospitals post payer-specific rates for all services and prices for their 300 most common procedures in a consumer-friendly format. However, PRA criticized the Biden administration for recent changes allowing hospitals to post percentages, algorithms, and, starting in 2025, estimates and averages instead of concrete pricing. PRA argued that these changes undermine the original intent of the regulations, enabling hospitals to obscure their prices further.
Cynthia Fisher, founder of PRA, called for stricter enforcement, accusing hospitals of “blocking American consumers from their right to compare prices and protect themselves from overcharges.” Fisher also urged President-elect Donald Trump to strengthen and enforce the price transparency rule in his upcoming term, reversing what she sees as rollbacks under the Biden administration.
To date, the Centers for Medicare and Medicaid Services (CMS) has fined only 15 hospitals for noncompliance, a small fraction of the 1579 hospitals identified as noncompliant in PRA’s review. Conservative lawmakers, typically proponents of less regulation, have voiced support for enhanced oversight. Last year, members of the House Ways and Means Committee criticized CMS for its lax enforcement, and Sen. Mike Braun (R-Ind.) introduced legislation aimed at strengthening transparency rules.
With nominations such as Robert F. Kennedy Jr. as Secretary of Health and Human Services (HHS) and Mehmet Oz as CMS Administrator, uncertainty surrounds the Trump administration’s health care agenda. However, advocates like Fisher are pushing for swift action, warning that without stricter penalties, hospitals will continue to withhold critical pricing information from patients.
“On behalf of all American healthcare consumers, please prioritize strengthening and enforcing the hospital price transparency rule immediately upon taking office. Please reverse the Biden administration’s rollbacks, and please issue financial penalties to noncompliant hospitals,” Fisher wrote.
Reference
HealthcareDive. Hospital price transparency continues to drop: report. Published November 22, 2024. Accessed December 19, 2024. https://www.healthcaredive.com/news/hospital-price-transparency-continues-drop-patient-rights-advocate/733703/
