Imaging prices are more difficult to track down for the average consumer compared to other shoppable healthcare services, according to a new transparency review incorporating thousands of U.S. hospitals.
Back in 2019, the Centers for Medicare & Medicaid Services mandated hospitals post their chargemasters online in a readable format. The goal was to steer patients toward lower-cost care and encourage high-cost systems to slash prices, researchers explained Friday in JAMA Network Open.
The impact of this CMS-1694-F rule 18 months later, however, revealed some discouraging results. More than half of the 5,288 U.S. hospitals with a website did not have an online chargemaster in a machine-readable format, as mandated by CMS.
And out of the 100 largest organizations, pricing for imaging services such as brain MRI, screening mammography and head CT without contrast, among others, proved exceedingly hard to find.
“Among 25 shoppable items, as deemed by CMS, both reviewers were able to identify 13.2% of prices,” Waqas Haque, MPH, MPhil, with the University of Texas Southwestern Medical School in Dallas, and colleagues explained in their research letter. “Imaging proved more difficult to find compared to medications and lab tests.”
In light of their findings, Haque and co-authors from Johns Hopkins, Southern Methodist University, and William Carey College of Osteopathic Medicine, say a majority of nationwide hospitals appear noncompliant with CMS’ ruling.
Their takeaways are based on a cross-sectional study of hospital chargemasters between June 30 and November 20, 2020. Out of the 5,000-plus healthcare organizations, 51.5% did not make an adequate online chargemaster available. This included 5.8% with broken links or files and 2.6% only offering an online cost estimator.
When such information was accessible, the researchers found chargemasters were often buried and difficult to use. It took a median number of 3 clicks (range of 2-8) to reach pricing info from homepages.
Greater compliance was associated with below-average patient experience and private nonprofit ownership. On the flipside, psychiatric hospitals (compared to acute care) and religious ownership were associated with noncompliance.
The hospital pricing data might not reflect actual charges, the authors noted, but their conclusions still suggest CMS’ goal of reducing healthcare costs may not be working.
“This work calls into question the effectiveness of CMS rulings to promote price transparency and highlights the challenges of creating effective price transparency tools for consumers,” Haque and colleagues explained.
Read the entire study here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.