A corridor in a hospital
Despite the best intentions of the federal Hospital Price Transparency Rule, many hospitals still are not providing the billing clarity and certainty that consumers expect.
“Our interim semiannual report exposes the most egregious practices by hospitals nationwide that are hiding their prices and forcing Americans to sign a blank check,” said Cynthia A. Fisher, founder and chair of the advocacy group Patient Rights Advocate. “Four- and-a-half years after the federal health care price transparency rule took effect, hospitals and insurers continue to flout the law.”
The rule, which became effective on Jan. 1, 2021, is aimed at helping consumers know the cost of a hospital item or service before receiving care. Hospitals operating in the United States are required to provide clear, accessible pricing information online about the items and services they provide, both as a comprehensive machine-readable file with all items and services, and in a display of shoppable services in a consumer-friendly format.
According to the report, however, many hospitals have stopped publishing actual prices in dollars and cents and instead post estimates, percents and algorithms, which are uninterpretable by everyday consumers. Among the key findings:
- Forty-three percent of reviewed hospitals are posting fewer prices now than in the November 2024 report.
- Two hundred and thirty-six reviewed hospitals failed to post any prices in actual dollars and cents.
- Three-quarters of reviewed hospitals posted algorithms that require interpretation by a contract expert.
- Half of reviewed hospitals posted algorithms that are unquantifiable because of ambiguity or missing information.
Even among hospitals that are posting pricing information, the report found wide price variation. For example, the price for cervical spinal fusion ranged from $650 to $25,100 at the University of Kansas Hospital’s main campus. In Florida, the price of mammograms of both breasts ranged from $32 at Cleveland Clinic Martin North to $15,000 at HCA Florida North Florida Hospital.
The report includes recommendations to improve the quality and accuracy of pricing data in machine-readable files, as well as technical suggestions to enable the technology needed for consumers to identify the vast price variation and make informed decisions to lower their costs. Patient Rights Advocate also submitted a comment letter to the Centers for Medicare & Medicaid Services with specific recommendations to strengthen and enforce the transparency rule to make it more useful and impactful for patients, employers, unions and taxpayers.
"We deserve prices, and with swift action from the Trump administration, all Americans will be one step closer to radical transparency, accountability and lower costs," Fisher said.
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