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Making a Case for Healthcare Pricing Transparency Tools

Updated: May 11, 2023

The following is an excerpt summary. Read the full article here.

In June 2022, two Georgia hospitals were fined more than $1M for noncompliance with the Centers for Medicare and Medicaid Services hospital price transparency rule. A February 2022 report by Patient Rights Advocate found that only 14% of hospitals had fully complied with the pricing transparency rule a year after the deadline.

The rule, which went into effect on 1 January 2021, requires hospitals to post standard charges in two ways: a machine-readable file and a consumer-friendly display. Hospitals weren’t the only target of price transparency legislation. Health plans are also required to meet certain price transparency milestones — though they have a bit longer to hit their goals. Requirements for health plans are divided into three phases, with staged deadlines in 2024.

Price transparency solutions can help hospitals and health plans compete in the healthcare market and position these solutions as a benefit to consumers in their marketing efforts.

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