Price Transparency

Little progress made with hospital price transparency compliance

March 13, 2024 - Hospitals have made little progress with implementing federal price transparency requirements that took effect in 2021. The latest semi-annual “Hospital Price Transparency Report” from PatientRightsAdvocate.org found that only about a third — 34.5 percent — of 2,000 hospitals reviewed were fully compliant with the price...


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Healthcare Consumers Want Hospital Price Transparency, Survey Finds

by Victoria Bailey

Healthcare consumers support price transparency, with many wanting hospitals to publish actual prices in advance, not estimates, according to a survey from PatientRightsAdvocate.org. The survey,...

The Role of the Hospital Chargemaster in Revenue Cycle Management

by Editorial Staff

The hospital charge description master, or hospital chargemaster, is at the heart of the healthcare revenue cycle, serving as the hospital’s starting point for billing patients and payers. A hospital chargemaster lists all the...

House Bill Addresses Price Transparency, Site-Neutral Payment Policies

by Victoria Bailey

The US House of Representatives has passed a bill to improve healthcare price transparency and establish site-neutral payment policies for drug administration. The Lower Costs, More Transparency Act...

CMS Will Issue OPPS Providers Lump-Sum Payments to Remedy 340B Losses

by Victoria Bailey

Hospital Outpatient Prospective Payment System (OPPS) providers participating in the 340B drug pricing program will receive a one-time lump-sum payment to offset losses between calendar years (CYs)...

Hospital Prices Online Are Not Aligned With Prices Offered via Telephone

by Victoria Bailey

Hospital prices posted online for vaginal childbirth and brain magnetic resonance imaging (MRI) did not match the prices offered to a secret shopper via telephone, indicating poor price...

Healthcare Orgs Address Price Transparency, 340B Policies in OPPS

by Victoria Bailey

Hospital and specialty groups are urging CMS to amend aspects of the CY 2024 Outpatient Prospective Payment System (OPPS) proposed rule, including 340B Drug Pricing Program policies and price...

Exploring Front-End Revenue Cycle, How to Optimize Its Performance

by Jacqueline LaPointe

The healthcare revenue cycle is broken down into three parts: the front-end, mid-cycle, and back-end. Much focus goes into mid and back-end functions, such as coding and billing, claims management, and denials management. However, what...

Hospitals, Health Systems Recognized for Price Transparency Compliance

by Victoria Bailey

Fifteen hospitals and health systems have been recognized for their compliance with the federal price transparency regulations. PatientRightsAdvocate.org created The Price Transparency Champion Award...

What Technologies Do Providers Need for Value-Based Care Success?

by Victoria Bailey

Value-based care models incentivize healthcare providers to improve care delivery by tying reimbursement to care quality. While value-based care holds providers more accountable for patient health outcomes, it also affords them the...

Two Years In, Hospital Price Transparency Compliance at 36%

by Sarai Rodriguez

Two and a half years in, most hospitals are still seemingly ignoring the federal Hospital Price Transparency Rule, with only 36 percent of facilities fully complying, according to...

OPPS Rule to Update Outpatient Payments, Hospital Price Transparency

by Jacqueline LaPointe

CMS proposes in the Outpatient Prospective Payment (OPPS) rule to increase Medicare outpatient payments by 2.8 percent next year while bolstering hospital price transparency enforcement. The OPPS rule...

Private Equity Acquisitions Led to Higher Prices at Physician Practices

by Victoria Bailey

Private equity acquisitions of physician practices are becoming more common, leading to price increases ranging from 4 percent to 16 percent, data from the American Antitrust Institute (AAI)...

Negotiated and Cash Prices are Lower at Physician-Owned Hospitals

by Victoria Bailey

Commercial negotiated prices and cash prices for common hospital procedures were lower at physician-owned hospitals compared to facilities not owned by physicians in the same region, a study published...

Healthcare Costs for Average Family Exceed $31K

by Jacqueline LaPointe

Healthcare costs for Americans are climbing higher once again following slower growth and even a rare decrease during the COVID-19 pandemic, according to the latest Milliman Medical Index (MMI)...

AHA Makes Hospital Price Transparency Suggestions to Congress

by Jacqueline LaPointe

This week, the American Hospital Association (AHA) told Congress ways to improve hospital price transparency initiatives and compliance. The United States House Ways and Means Committee earlier this...

CMS Cracks Down on Hospital Price Transparency Compliance

by Jacqueline LaPointe

CMS is cracking down on hospital price transparency compliance — or lack thereof. The federal agency announced yesterday updated enforcement procedures, including earlier and automatic civil...

HHS Sheds Light on Hospice, Home Health Ownership Data

by Jacqueline LaPointe

For the first time, HHS is releasing ownership data on all Medicare-certified hospice and home health agencies in an effort to increase transparency and competition in healthcare. HHS announced...

Price Transparency Rule Compliance is Growing But Needs More Oversight

by Victoria Bailey

More than two years after the hospital price transparency rule went into effect, provider compliance is increasing, according to a report from Turquoise Health. The software company’s Price...

Hospital Chargemaster Heavily Influences Cash Prices, Payer Rates

by Jacqueline LaPointe

While neither patients nor payers typically pay what hospitals charge for services, a new Health Affairs study finds that those hospital chargemaster rates still matter. Researchers at Johns Hopkins...