The CMS Price Transparency Rule, implemented on January 1, 2021, requires hospitals operating in the United States to make standard charges for all items and services public.

To help hospitals adhere to this rule, CMS provides a list of 22 questions, which HDA uses to assess a hospital’s compliance with the final rule. We group the questions into five categories:          

  1.      General     
  2.      Format     
  3.      Data Elements
  4.      Accessibility     
  5.      Annual Updates     

Our data allows hospitals to visualize and review their compliance for each CMS requirement. Leveraging our analytics capabilities and these 22 questions, HDA established the HDA Compliance Score that summarizes each hospital’s level of compliance.

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Price Transparency Data Elements Are Vital to Remaining in Compliance

In order to better understand how HDA measures hospital compliance scores, let’s examine the UF Health Leesburg Hospital. This hospital receives an HDA Compliance Score of eight. It receives two points for meeting the accessibility requirements, but as seen below, loses two points because of deficiencies in data elements.

Price Transparency Data Elements are Vital to Remaining Compliant

Hospitals Demonstrate Compliance Inconsistencies Even Within a Health Network

HDA can summarize compliance scores across health networks. One would expect hospitals within the same group to have similar scores. However, we too often find that this is not the case.

For example, let’s look at the Wake Health network in North Carolina and the UF Health network in Florida. Four of the five Wake Health hospitals have public price transparency files posted on their websites and High Point Regional Health has not published any price transparency data to date.

Of the four hospitals that did publish, Lexington Memorial Hospital is the only one to not disclose cash or self-pay prices in their file. 

In the UF Health network, discrepancies are even more evident. The University Behavioral Center lacks cash and self-pay prices, CPT codes, and service descriptions, resulting in a HDA Compliance Score of five. UF Health Leesburg and UF Health The Villages are much closer to compliance at an HDA Compliance Score of eight. 

Wake Health Scores

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UF Health Scores

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Using these tables, we can calculate the average scores of each network. Wake Health’s average is an 8.7, while UF’s average score is 7.7.  If you or your group could use help assessing your own compliance with the CMS Price Transparency Rule, contact us to find out how HDA can help. 

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