Calculator and spreadsheet

When our recent investigation found that New York City’s public hospitals still have a long way to go when it comes to following  a federal mandate requiring price transparency, an expert in health policy told us that’s all too common. 

 Nationwide, all hospitals are required to post prices for their procedures and services on the internet. 

New York City Health + Hospitals, the corporation that manages all of these public facilities, has not complied, posting lists with conflicting data, our investigation found. Health + Hospitals has not replied to our requests for either an explanation or comment. So we reached out to Dr. Ge Bai, an expert and professor of health policy and management at Johns Hopkins University and author of a number of studies on the latest trends regarding this transparency legislation that came on the books Jan. 1, 2021.

When we told Dr. Bai that our NYCH+H research turned up confounding results, she told us that even though there is not much data available on hospital compliance with the relatively new mandate, she was not surprised.

“I have heard anecdotal evidence, saying hospitals do not disclose accurate prices for some procedures” she told ClearHealthCosts in a phone interview. “But I haven’t seen any study using a large-scale sample to tackle this question.”

In the first few months of 2021, when the law first came into effect, hospitals around the country were sluggish about publishing their prices, but now, almost two years later, many more have fallen in line. Yet the system is still not functioning as it is supposed to, for two main reasons.

First,  Bai said that although the rate has increased, “We still have a pretty severe non-compliance issue,” she said. “I believe right now roughly 1/3 probably [of hospitals] have some non-compliance issue.”

Quality control is lacking

The second issue, she said, is one of quality control, meaning that it is still very difficult to assess whether the reported prices  are in fact accurate.

“Even if [hospitals] post their prices, we don’t have any studies so far for validating the posted price,” she said. But based on research she has seen, she believes that most hospitals that are disclosing their information are doing so in good faith: not deliberately misleading the public.

As far as prices are available and accurate, Dr. Bai has heard anecdotal evidence that the transparency policy is starting to work as it was intended to.

“Many payers, especially self-insured employers who have skin in the game, pay more if the prices are higher,” she said. “So they are actively using that data, trying to identify cheaper providers and cheaper hospitals to steer patients to those hospitals.”

Dr. Bai also said that, despite price transparency being a bipartisan issue, very few hospitals have been cited or penalized for not following the law.

Over at Newsy, Amber Strong reported recently  that enforcements have been lax. “The federal government has fined two hospitals a little more than $1 million for noncompliance,” she wrote. “A spokesperson told Newsy as of October 2022, it has issued 388 warnings and requested 204 corrective action plans, adding that 243 hospitals had addressed previous citations.”

Bai said: “I think maybe there’s a limit on the regulatory labor force, their energy, their attention. “But also, I think there are other priorities taken by this administration. Their actions show that price transparency is not on the top of their priority list.”

Virginia Jeffries

Virginia Jeffries is a journalist in New York City. Since 2020, she has reported on long...