June 27, 2022

Most hospitals not providing price information for TJAs as required by CMS

By: Judy Mathias

Editor's Note

This study from the Cleveland Clinic finds that less than one-third of US hospitals were fully compliant in 2021 with the transparency in pricing for total joint arthroplasty (TJA) rule mandated by the Centers for Medicare and Medicaid Services (CMS).

Of 400 hospitals analyzed between December 1 and December 20, 2021, only 32% were compliant with all six requirements under the rule. A total of 21% of hospitals provided CMS-compliant pricing for knee replacement and 18% did so for hip replacement.

The researchers also looked at whether hospitals provided the total charge for the procedures. They found that 36% gave the total charge for knee replacement and 31% gave the total charge for hip replacement.

In addition, 13% of hospitals violated the rule by not providing machine-readable files, and many hospital websites were lacking in consumer friendliness, although this was not required in the rule.

 The researchers note that it is possible that hospitals have delayed compliance in hopes that the requirements may change or that delays in enforcement may continue.


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