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Most Hospitals Not Complying with Price Transparency Rules, Study Finds


A new study in the Journal of General Internal Medicine finds compliance remains lacking a year after federal price transparency rules went into effect.

Most U.S. hospitals — 55 percent — are not complying with price transparency rules, according to a new study from researchers at the Johns Hopkins Bloomberg School of Public Health.

The study ranked publicly available hospital compliance information for all 50 states, the District of Columbia, and 305 geographic regions in the U.S., according to a news release. The researchers based their analysis on files from more than 3,500 U.S. hospitals in the first five months of 2021, January 1 through June 1.

The researchers found a great deal of variation between states in complying with the rule that went into effect in January 2021. Some states, such as Michigan and Hawaii, have more than 75 percent or of hospitals in compliance, while others have seen compliance rates beneath 25 percent, including Maryland and Louisiana.

The study, “Factors Associated with Compliance to the Hospital Price Transparency Final Rule: A National Landscape Study” was written by John Jiang, Daniel Polsky, Jeff Littlejohn, Yuchen Wang, Hossein Zare, and Ge Bai. It was published Dec. 9 in the Journal of General Internal Medicine.

One interesting finding was that hospital compliance was strongly associated with the average compliance level of peer hospitals in the same regional market. A hospital would be 42 percent more likely to be compliant if all other hospitals in the same geographic region were compliant as well, according to the news release.

“The findings suggest that hospitals do not make decisions in isolation, rather their decisions reflect market pressure from their peers,” says the study’s senior author, Ge Bai, PhD, CPA, professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and professor of accounting at the Johns Hopkins Carey Business School.

The Hospital Price Transparency Rule — managed by CMS — requires individual hospitals to provide clear pricing information online about the services they provide. Hospitals must include standard pricing for at least 300 services, ranging from colonoscopies to CAT scans.

The rule is designed to allow patients to compare prices and estimated cost of services. It can also help patients make more informed decisions about care, increase hospital competition, and potentially drive down costs.

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