September 30, 2021

Pull Back the Curtain on Price Transparency

To make smarter healthcare decisions, healthcare price transparency is key. Learn about the Hospital Price Transparency Rule and other transparency tools available to your employees that can lower healthcare costs.

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Did you know that the U.S. spends more on health care than any other high-income country in the world, yet has the highest chronic disease burden and double the average obesity rate?

In response to such poor outcomes from extraordinary healthcare spending, the Hospital Price Transparency Rule went into effect on January 1, 2021. This rule requires hospitals to inform consumers about the prices they charge. This rule is intended to promote competition in the healthcare space and help make your employees smarter healthcare consumers. It does this by mandating that each hospital within the US provide clear, accessible pricing information online about the items and services the hospital provides; meaning that your employees will have tools at their disposal they can use to become smarter healthcare consumers.

 

The Current State of Hospital Price Transparency Rule

According to the rule, each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide in two ways:

– As a comprehensive machine-readable file with all items and services; and

– In a display of shoppable services in a consumer-friendly format.

Although this rule universally rolled out at the start of 2021, many hospitals and healthcare providers who fall under the rule have yet to implement system, citing a lack of IT resources to implement comprehensive price transparency data. Currently, there is a $300 a day fine in place for those hospitals that are noncompliant. However, many hospitals and healthcare providers are complying with the new rule in an effort for full disclosure. Learn more about Transparency in Coverage in our recent Compliance Update.

 

Other Tools for Transparency

Disclosure alone likely isn’t enough to curb healthcare costs but, it is one of many tools used to empower your employees with the price knowledge they need to make smarter healthcare decisions.

Aside from the new transparency rule, you and your employees may not be aware of the disparities that exist in healthcare pricing. Prices for common procedures, such as an abdominal ultrasound can vary by over 1,000% within the same ZIP code. With cost variances this staggering, employers aren’t waiting for compliance and transparency. Employers are seeking resources and healthcare partners, like Healthgram, that help their employees make sense of healthcare pricing and make smarter healthcare decisions.

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