(HealthDay News) — Few hospitals are fully compliant with price transparency rules, according to a research letter published in the June 7 issue of the Journal of the American Medical Association.

Waqas Haque, M.D., from New York University Langone in New York City, and colleagues collected data on 5,239 hospitals’ characteristics and adherence to the final rule between July 1 and Sept. 30, 2021. This included the five required price types (gross charges, discounted prices, payer-specific negotiated prices, and minimum and maximum negotiated prices) in a machine-readable file, and a separate accessible display or price estimator for at least 300 shoppable items.

The researchers found that 13.9 percent of hospitals had an adherent machine-readable file but no shoppable display and 29.4 percent had an adherent shoppable display but no machine-readable file, while 5.7 percent had both. Half of hospitals (50.9 percent) had neither an adherent machine-readable file nor a shoppable display.


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There was no significant association seen between total gross revenue and final rule adherence, while being in the lowest quartile of revenue per patient-day was associated with greater rates of adherence than other quartiles.

Being in a moderately concentrated market versus an unconcentrated market was associated with worse adherence (odds ratio, 0.58) as was being in a highly or very highly concentrated market (odds ratio, 0.33) versus being in unconcentrated markets.

Urban location was associated with better adherence to the final rule (odds ratio, 1.86) than rural location, while hospital size, emergency service capabilities, and hospital ownership were not associated with adherence.

“Adherence to the final rule price transparency mandate six to nine months after its effective date was low,” the authors write.

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