June 28, 2023

Compliance with CMS Hospital Price Transparency Rule linked to financial penalties

Editor's Note

This study from Harvard Medical School, Boston, and Georgetown University, Washington, DC, finds that hospital compliance with the Centers for Medicare & Medicaid Services (CMS) 2021 Price Transparency Rule is increasing since financial penalties were enforced.

Data from 4,377 acute care hospitals operating in 2021 and 2022 were included in the analysis.

Among the findings:

  • Compliance increased 17.3%, from 70.4% (3,082) in 2021 to 87.7% (3,841) in 2022, with 90.2% (3,948) of hospitals reporting prices in at least 1 year.
  • Noncompliance penalties increased from $109,500 per year in 2021 to a mean of $510, 976 per year in 2022.
  • Penalties in 2022 averaged 0.49% of total hospital revenue, 0.53% of total hospital costs, and 1.3% of total employee wages.
  • A $500,000 increase in penalty was associated with a 2.9% increase in compliance.

The researchers concluded that the findings are relevant for the enforcement of other regulations that promote transparency in healthcare.

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