Hospitals: A January 1, 2021, federal regulation requires hospitals to post machine-readable data files of standard charges on their websites. This includes gross charges, payer-specific negotiated rates, de-identified minimum and maximum charges, and discounted cash price for all items and services provided by the hospital. This is a major step forward in requiring hospitals to be transparent and accountable in pricing health services.
Hilltop researchers examined hospital pricing data to assess compliance with the new regulations at the 100 largest US hospitals. About 65% of these hospitals were “unambiguously noncompliant,” although compliance has been rising over time. Hilltop researchers investigated discounted cash prices and, for 1600 hospitals, examined variation in emergency room “facility fee” cash pricing. An article in JAMA Internal Medicine examines the concordance of hospital price transparency data with telephonic pricing estimates.
While hospitals are required to publicly post pricing data files, a standardized data format is not required. As a result, these files are difficult to use for research. With funding from a National Science Foundation “Build and Broaden” grant, Hilltop is collecting, processing, and posting data from hundreds of hospitals across 22 states. The data have been transformed into a common data model to facilitate cross-hospital research. The Price Transparency State Profiles provide free access to this data along with links to state legislation on hospital price transparency.
Health Plans and Insurance Issuers: The July 1, 2022, Transparency in Coverage rule requires group health plans and insurance issuers to post machine-readable data files of the prices they negotiate with in-network providers. Hilltop researchers studied the utility of these data files to better understand provider reimbursement and examined the lack of compliance reporting with this new federal regulation.
To learn more about this research, see In the Literature below.
Hilltop thanks Arnold Ventures and the National Science Foundation for generously funding this research.
The Price Transparency State Profiles include access to the price transparency laws that states have passed as of July 2023.
The Profiles also include access to hospital price transparency data that has been cleaned and organized by state, as well as information about the hospitals from which data has been collected.
Click on the map to the right to access the State Profiles.