Effective since Jan. 1, 2021, the Hospital Price Transparency Rule is the federal government's attempt to make health care pricing more transparent for patients. The goal is to make hospital services "shoppable" and eventually drive down costs for consumers. Nearly two years since this Rule took effect, almost two-thirds of hospitals are in compliance, according to one survey. Why does it still feel like nothing has changed?

To comply with this Rule, hospitals must make their standard charges publicly available online in two ways. First, they must post their chargemaster, which includes standard charges for all hospital items and services, in a comprehensive machine-readable file. Second, the chargemaster must include a consumer-friendly display that includes standard charges for at least 300 shoppable services customarily provided by the hospital.

Transparency is lagging

Initial adoption to comply with this Rule has been slow. In fact, one study analyzed 5,000 hospitals in the six to nine months after Jan. 1, 2021 and found less than 6% of those hospitals were in compliance. Another audit found that many hospitals are partially complying but missing key information for patients. For example, more than 60% did not publish a sufficient amount of negotiated rates, while several others did not publish any discounted cash prices. The lack of incentive for hospitals to comply has led to this slower than anticipated adoption by some and the acceptance of a daily fine for non-compliance by others.