Findings Signal Low Hospital Compliance With Price Transparency Mandate

More than 1 year after the Price Transparency Final Rule went into effect, less than one-third of US academic medical centers appeared to comply with the mandate—and among those that did, the prices of 5 common urologic procedures varied substantially. Researchers published their findings in JAMA Network Open.

 “Patients with urologic diseases often experience financial toxicity, defined as high levels of financial burden and concern, after receiving care,” wrote corresponding author Zeynep G. Gul, MD, of the University of Washington in St. Louis Division of Urology in Missouri, and coauthors. “The Price Transparency Final Rule, which requires hospitals to disclose both the commercial and cash prices for at least 300 services, was implemented to facilitate price shopping, decrease price dispersion, and lower health care costs.”

The study looked at the prices of cystourethroscopy, prostate biopsy, laparoscopic radical prostatectomy, transurethral resection of the prostate, and ureteroscopy with laser lithotripsy at 153 academic hospitals in the United States. Researchers used the Turquoise Health Database to identify the cash price, Medicare price, Medicaid price, and commercial insurance price for each procedure on March 24, 2022. Implementation of the Price Transparency Final Rule was January 1, 2021.

Compliance with the price transparency legislation was low, according to the study, with just 29% of hospitals in the study reporting a price for laparoscopic prostatectomy. A mere 13% listed commercial prices for all 5 urologic procedures.

The price of each procedure varied substantially by hospital, the study found. Furthermore, there were significant price differences in price by insurance type. At 16% of hospitals, the cash price was actually the lower than the Medicare, Medicaid, and commercial prices.

“The Centers for Medicare & Medicaid Services may improve price transparency by better enforcing penalties for noncompliance, increasing penalties, and ensuring that hospitals report prices in a way that is easy for patients to access and understand,” researchers advised.

Reference:
Gul ZG, Sharbaugh DR, Guercio CJ, et al. Large variations in the prices of urologic procedures at academic medical centers 1 year after implementation of the Price Transparency Final Rule. JAMA Netw Open. Published online January 3, 2023. doi:10.1001/jamanetworkopen.2022.49581