With the aim of promoting price transparency in healthcare, the Federal Government issued final regulations on November 27, 2019 requiring hospitals to publicly post price information for their healthcare services. To develop a preliminary regional assessment of compliance with its Price Transparency of Hospital Charges Final Rule, HealthPriceCompare examined all hospitals in the Richmond, Virginia Metropolitan Statistical Area (MSA). This MSA was chosen due to its relative population density and the existence of both independent and national chain hospitals in the area.
Hospitals were assessed on key regulatory requirements that became effective on January 1, 2021. The first was determining if the machine-readable file containing the required price information for all services had been publicly posted in .CSV, .XML or .JSON file formats. The second was determining if the data in the machine-readable file contained the twelve required data elements for each healthcare service. The third was determining if the machine-readable file is displayed prominently and easily accessible on the hospital website. Due to the lack of a specific threshold for meeting the displayed prominently and easily accessible standard, HealthPriceCompare developed an assessment methodology based on click-depth (i.e. mouse clicks) needed to navigate to the file from the hospital home page.
We concluded that most hospitals in the Richmond MSA were deficient in their compliance with the transparency regulations. In some cases, hospitals took no action to be compliant and were consequently assigned an overall compliance level of Not Applicable (N/A).
Encompass Health, which operates two rehabilitation hospitals, had the highest level of regulatory compliance in addition to providing an exceptionally smooth experience for consumers looking to research prices on their website. In contrast, Vibra Hospital of Richmond, Poplar Springs Hospital (owned by a subsidiary of Universal Health Services which is one of the largest hospital operators in the nation) and Cumberland Hospital were assigned an N/A rating because no compliance action has been taken to date.
Bon Secours, a not-for-profit health system that has a substantial market position compared to its competitors, scored the same on all measures of compliance at each of its five hospital locations. A significant area of weakness was their posting of the machine-readable file in .JSON file format which, while permitted in the regulations, could not be accessed. The VCU Medical Center also made for an interesting case because it presented its prices as a percentage of Medicare or Medicaid. This method of expressing prices is not immediately useful to a regular healthcare consumer and we should expect regulatory action to remedy the use of this methodology.
The purpose of our efforts to assess compliance with the Price Transparency of Hospital Charges Final Rule is to highlight progress and identify areas of compliance weakness in the Richmond, VA MSA. HealthPriceCompare will leverage this approach to continue monitoring the progress that hospitals in Richmond, as well as other areas of the United States, are making to meet the standards of the regulations.
©2022 HealthPriceCompare LLC - All Rights Reserved.
CPT© copyright 2022 American Medical Association. All Rights Reserved.