Every person should have the right to know what a health care procedure costs at different hospitals or health care facilities, whether it is an X-ray, an MRI, or a surgery, yet that is not how it works in the U.S. health care system. By keeping health care prices hidden from policymakers, researchers, and purchasers including consumers, hospitals and other providers have been able to avoid oversight and scrutiny. Unveiling health care prices, and specifically the negotiated rate, is a key tool to rein in abusive pricing practices and infuse competition back into US health care markets.
Following years of consumer advocacy, the Centers for Medicare & Medicaid Services (CMS) finalized the Hospital Price Transparency rule, requiring hospitals to make public their standard charges for the care they provide. However, more than two years after the Hospital Price Transparency rule took effect, far too many hospitals across the country remain out of compliance with the federal rule. Hospitals are deploying various tactics to either buck the requirements outright or make the information they are disclosing very hard to understand.
Achieving full price transparency is a critical step toward driving value into the U.S. health care system and ensuring our nation’s families receive the affordable, high-quality care and improved health they deserve. CMS should strengthen the Hospital Price Transparency rule by requiring standardized reporting to ensure that the price information hospitals post is useful for consumers and increasing and regularizing enforcement and oversight to drive compliance by hospitals. Further, Congress should conduct its own hearings and oversight to highlight low hospital compliance and codify a strengthened Hospital Price Transparency rule into law.