Rebuttal Health Admin Week Db Post
Rebuttal Health Admin Week Db Post
Rebuttal Health Admin Week Db Post
The author offers a captivating discussion of healthcare challenges the US healthcare system is facing, including prince transparency, underfunding of Medicare and physician shortages. Indeed regulatory bodies have failed to ensure price transparency since the passing of the Hospital Price Transparency Final rule that requires healthcare providers to present payer-specific negotiated prices, standard charges for every healthcare item and service, and discounted prices, which became effective on January 1, 2021.1 This rule also requires healthcare organizations to publish a customer-friendly list of this price-related information. Existing research shows a low compliance rate, at about 33%.2 By September 2021, over half of the hospitals registered with the CMS had not posted a machine-readable file or shoppable services. However, there have been measures to curb the low compliance rate, including the CMS introducing penalties for noncompliance, $300 per day for small hospitals and upwards of $5,500 per day for larger hospitals, effective January 1, 2022.2 Nonetheless, the compliance has remained low, between 29% and 56%, per different reports.
The hospitals have also been misreporting, intentionally stating lower figures than the median. For instance, the CMS established that among 70 shoppable services it specified, almost half of the hospitals disclosing cash and commercial prices quoted cash prices lower than the median commercial prices, about 17% of all hospitals.2 To address this issue, it is critical to answering these questions: did the price transparency rule low commercial prices for hospitals? Why are many hospitals still non-compliant with the rule? What are their concerns or negative implications of disclosing healthcare prices? What is the reason for the significant variations in prices between and within hospitals? Answering these questions would allow appropriate authorities to design strategies to enhance healthcare price transparency, lower healthcare costs, and facilitate comparison shopping for patients and payers.
References
Chen J, Miraldo M. The impact of hospital price and quality transparency tools on healthcare spending: a systematic review. Health Economics Review. 2022 Dec;12(1):1-2.
Jiang JX, Krishnan R, Bai G. Price Transparency in Hospitals—Current Research and Future Directions. JAMA Netw Open.2023;6(1):e2249588. doi:10.1001/jamanetworkopen.2022.49588 https://pubmed.ncbi.nlm.nih.gov/36602805/
