News: Comparison shopping difficult among providers despite price transparency rule

A study from the Kaiser Family Foundation found that despite the price transparency rule that went into effect in January, comparison shopping for patients has still been difficult. The difficulty with comparison among providers stems from the fact that few hospitals are publishing payer-negotiated rates, the study explains.

“Among the few hospitals in this analysis that do provide payer-negotiated rates, the markets in which the payer operates is not always clear […] And, due to a lack of standardization, comparing process across hospitals is problematic,” the study says.

Comparison difficulties also arise because few hospitals distinguishing price differences between inpatient and outpatient care, and hospitals don’t always make clear if the price estimate includes a professional fee or not.

“While some hospitals included both facility and professional fees (e.g., for physician services) in their estimate, others opted to just include the facility fee in their total price estimate,” the study says. “The results from implementation thus far demonstrate a wide range in interpretation and compliance with the hospital rule and may suggest similar challenges with implementation of the insurer-focused rule in 2022 if standardization is not enforced.”

Editor’s note: The Kaiser Family Foundation study can be found here. Additional ACDIS coverage of the price transparency rule can be found here.