In the ABA’s Health eSource Newsletter, Analysis Group Authors Identify Potential Pitfalls in the Use of Hospital Pricing Data Posted Under CMS’s New Price Transparency Rule
September 13, 2021
In an article appearing in the ABA’s Health eSource newsletter, Principal Mark Gustafson, Vice President Hristina Bojadzieva Bartlett, and Manager Phil Hall-Partyka comment on the quality, completeness, and utility of pricing data posted on hospital websites under the Centers for Medicare & Medicaid Services’ Price Transparency Rule, which went into effect on January 1, 2021.
In the article “When it Comes to the Price Transparency Rule, Not All Data is Created Equal,” the authors note that the type of information required under the rule, including descriptions of services, billing codes, and a range of charges, is much sought after in certain types of litigation over the “reasonable value” of healthcare services.
However, their review of the data posted to date by selected hospitals identified potential pitfalls that a user of the data should consider prior to drawing any conclusions. The authors provide examples of different forms of non-compliance on the part of hospitals, as well as of differences in reporting from hospital to hospital and of underlying complexities that may limit the usefulness of the data as published.
Until compliance improves and the published data becomes more uniform, they conclude, care must be taken to develop appropriate strategies for effectively leveraging the available data.