Improving Hospital Compliance With Price Transparency Rules.

The Hospital Price Transparency Rule, effective January 2021, mandates that U.S. hospitals publicly post prices for 200 shoppable services in a machine-readable format, with penalties for noncompliance. Yet, compliance has been uneven: only 57% are fully compliant, while 31% report partial compliance; some studies show compliance as low as 36%.

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Noncompliance stems from several factors:

• Hospitals needing more time or resources to compile accurate data;
• The high cost of compliance itself;
• Concerns that disclosing negotiated rates might weaken their competitive bargaining position—although Transparency in Coverage rules now require payers to report those rates independently, reducing this concern.

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To address these challenges, the article proposes several policy interventions:

1. Substantially raise enforcement penalties: CMS has already increased fines up to $2,007,500 annually for large hospitals—aligning the cost of noncompliance with, or exceeding, the cost of compliance.
2. Capitalize on payer-based transparency initiatives: As insurers are required to disclose negotiated rates under new Transparency in Coverage policies, hospitals' compliance—or lack thereof—has less competitive risk.
3. Launch public awareness campaigns: Informing consumers about price transparency and its benefits could drive demand for the data, increase usage, and incentivize hospitals to comply.

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Overall, achieving the goals of transparency—empowering consumers and encouraging healthcare competition—requires both stronger enforcement and enhanced public engagement.