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Not many hospitals disclosing prices despite new rule seeking transparency

Cancer Drug Prices
Posted at 3:28 PM, Feb 01, 2021

It's been one month since a new rule went into effect requiring hospitals to disclose the prices they privately negotiate with insurers and provide cost estimator tools for patients.

This is all supposed to give you more transparency with what you're paying and help you to shop around. However, we're learning not many hospitals are posting the prices yet.

Ge Bai, an expert on health care pricing, says right now only about 20% of hospitals across the country are complying with the new rule.

Some of what hospitals are posting online is a machine-readable file that Bai says will be hard for patients to get the price information they need from.

“That information will feed into third-party information platforming companies. So, these companies will gather that and then put it into a more friendly, consumer friendly format, so we patients can go to the third-party platform website to find out what is the cheapest option for us,” said Bai, PhD, CPA, an associated professor of accounting at the Johns Hopkins Carey Business School.

She says several third-party platforms are trying to get into the market now. So, we'll have to wait and see which is the best option.

The pandemic is part of the delay in some hospitals posting prices.

The executive vice president for the American Hospital Association tells us some of the same finance, billing and its staff that manage the public health emergency and administration of vaccines are now being diverted to work on the lengthy machine-readable files required by HHS. But the pressures of fighting the virus did not go away because of a Jan. 1 deadline.

Bai says there's a hope that eventually the new rule will reduce prices.

“So, let's say we are very competitive market, meaning that there are several hospitals, and they are competing for our services. In that situation, the price transparency rule might be very helpful,” said Bai. “Now, hospitals have to disclose. They want to compete against each other to provide the best service at the lowest price. That will benefit the consumers.”

The American Hospital Association is urging the Biden administration to change part of the new rule. It believes requiring disclosure of privately negotiated rates will accelerate anti-competitive behavior among commercial health insurers.