Know What You’ll Pay Before Receiving Hospital Services

There are a lot of problems with our healthcare system. The most concerning of which is the cost of healthcare. For a lot of people, it’s difficult to afford proper healthcare. They’re either dealing with high premiums or out-of-pocket expenses that stress their budgets. The majority of bankruptcies in the U.S. are also due to medical bills. That’s why more and more people are skipping healthcare services, even when they have insurance. Luckily, we’re making headway in one area related to healthcare spending, and that’s price transparency. Knowing what you will pay before agreeing to service will make financial planning more manageable and ensure you won’t be surprised when the bill comes. This new Price Transparency Rule was issued by the Centers for Medicare & Medicaid Services (CMS), a U.S. federal agency in the Department of Health & Human Services. Learn more from the resources below.

hospital pricing

On January 1, 2021, the Hospital Price Transparency Final Rule went into effect. Per the Federal Register, “This final rule establishes requirements for hospitals operating in the United States to establish, update, and make public a list of their standard charges for the items and services that they provide.” The rule requires hospitals to provide an up-to-date list of standard service charges online so that the public (patients, employers, third parties, etc.) can estimate the cost of services before receiving them and easily compare prices since costs vary significantly by hospital and location. This rule aims to improve price transparency and help everyone make informed decisions about the healthcare they receive. They also think price transparency will ultimately increase market competition and drive down costs related to hospital items and services.

Hospital Price Transparency Rule

More Resources on the Hospital Price Transparency Rule

Hospital Price Transprarency by CMS
*Brief summary of the Hospital Price Transparency Rule and more information for hospitals and consumers

A Complete Report by the Federal Register on the CMS Rule
*Rules and regulations related to price transparency and the requirements for hospitals to make standard charges public

Hospital Price Transparency Final Rule Presentation
*Additional information on who must comply with the rule, what are ‘standard charges,’ what services are included, how will monitoring & enforcement be handled, and more

Hospital Price Transparency FAQ by CMS
*FAQs and examples covering almost every topic related to Hospital Price Transparency

Compliance Issues from Hospitals

As you can imagine, compliance is a big factor for the Price Transparency Rule to work effectively. There is criticism that many hospitals are not adequately complying with the requirements of the final rule. We’ve gathered a couple of resources below if you’d like to learn more about compliance concerns in the months following the Price Transparency Rule going into effect.

CMS Price Transparency Rule

Health Affairs Blog: Low Compliance From Big Hospitals on CMS’s Hospital Price Transparency Rule

Peterson-KFF Brief: Early results from the federal price transparency rule show difficulty in estimating the cost of care