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Study Finds Most U.S. Hospitals Remain Noncompliant in CMS Mandated Hospital Price Transparency

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A study, published in JAMA Network Open, found that most US hospitals remained noncompliant with the CMS-1694-F ruling, effective on January 1, 2019, which mandated that hospital chargemasters be publicly available in a machine-readable file. The study also found that compliance was associated with patient ratings, hospital type, and ownership. Even when publicly accessible, chargemasters were frequently buried within websites and difficult to use accurately, calling into question the effectiveness of CMS rulings to promote price transparency and highlights the challenges of creating effective price transparency tools for consumers.

Researchers reviewed 5,288 US hospitals associated with a website, most of which were located in urban settings. A total of 2723 hospitals (51.5%) did not have an online chargemaster in a machine-readable format, including 305 hospitals (5.8%) with broken links or incorrectly linked files and 138 hospitals (2.6%) that only provided an online cost estimator.

Researchers concluded that additional data, including negotiated rates mandated in the final rule on price transparency (CMS-1717-F2), may improve the interpretability of hospital prices, but that rule does not address improving access and usability of hospital pricing data. One limitation of this study is that hospital pricing data may not reflect actual charges or costs.

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