healow Price Transparency shown on laptop

Transparency rules are here, but compliance lags

Knowing what things cost in healthcare is a perennially popular idea among consumers and regulators. However, putting complete and accurate information about healthcare costs in front of consumers has proven to be more difficult than anticipated.

More than a year after federal price transparency rules took effect on January 1, 2021, the majority of hospitals nationwide have yet to comply fully with the regulations. According to a February report in Revcycle Intelligence, only 14.3% of 1,000 hospitals surveyed by a consumer advocacy group were in full compliance with the law.

That means that about 85% of hospitals have yet to comply with at least one aspect of the legislation, notably a requirement that standard charges for all services be posted in a machine-readable format on the institution’s website.

The Revcycle report notes stronger compliance (28%) with the rule that hospitals list the charges for their 300 most common procedures in a consumer-accessible way.

healow Price Transparency can help

Whatever the reasons behind noncompliance, the reality is that federal rules on price transparency aren’t going away, making it important that hospitals find ways to meet their legal obligations.

We developed healow Price Transparency to help them do exactly that and, as or more importantly, to give consumers the information they want about costs.

By adding a widget to their website, hospitals using healow Price Transparency can give patients and potential patients the information necessary for more-informed choices about where they will obtain the care they need and how much they will be able to afford.

healow Price Transparency shown on laptop

Key features available to patients

  • Patients can type in the procedures they are interested in and their ZIP Code to generate a list of which facilities in their area offer such services
  • By entering their insurance information, copayments, and any deductibles, patients can obtain an estimate for what they will pay out of pocket for a given procedure
  • Patients can compare mortality rates to see how the hospital they are considering compares with national averages or other hospitals in their area

More rules coming in July 2022 and beyond

Rates of compliance are expected to increase in the coming months as the healthcare industry prepares for additional regulations around price transparency.

According to the Centers for Medicare & Medicaid Services (CMS), beginning on July 1, 2022, the Transparency in Coverage rule will impose new requirements on healthcare payers — that is, insurance plans.

“Most group health plans and issuers of group or individual health insurance will begin posting pricing information for covered items and services,” CMS notes, adding that additional requirements will arrive on January 1, 2023, as well as January 1, 2024.

Your best bet against uncertainty

It remains to be seen how the healthcare industry will deal with the coming waves of regulations, and whether Congress will move to increase enforcement efforts and monetary penalties for noncompliance in the months and years ahead.

But whatever the shape of the political and regulatory landscape, price transparency is likely to remain a key priority for consumers, consumer advocates, and policy makers. And healow will remain committed to helping our customers meet their legal obligations with healthcare IT tools that can both educate consumers and help control costs for all.

To learn more, email sales@healow.com or visit our website.

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