“The Biden administration could stand to take a firmer hand on hospital price transparency, especially when it is unclear whether the price data being published are even accurate, the Government Accountability Office (G.A.O.) wrote in a Wednesday report,” Dave Muolo writes over at Fierce Healthcare. “The Centers for Medicare & Medicaid Services (C.M.S.) has required hospitals to post the prices for numerous services annually and this past summer raised the bar by ensuring hospitals were doing so using a standardized file format. Numerous reports from stakeholders criticized hospitals’ compliance along the way, with hospitals themselves often saying that the requirements were burdensome and often too vague. On instruction from Congress, the G.A.O. conducted a review of the requirements, the C.M.S.’s enforcement and whether the agency’s policy was successfully serving patients, payers and researchers. The G.A.O. interviewed 16 stakeholder groups — representing those three groups — who described difficulties making effective comparisons and compiling the data for large-scale use. These hurdles were tied to inconsistent file formats, pricing complexities that came across poorly in the machine-readable format and what they perceived to be incomplete and inaccurate data sets. ‘While the use of hospital price transparency data has been limited so far, many stakeholders we interviewed noted that they expect use to increase over time if the data usability challenges are overcome or addressed,’ the G.A.O. wrote in the report. … When reviewing the C.M.S.’s enforcement efforts, the office found that, from 2021 through 2023, the C.M.S. had initiated 1,287 enforcement actions, about two-thirds of which came in the final year. The enforcement actions most often cited deficiencies related to missing data (43% of actions), no machine-readable file (34%) and noncompliance related to shoppable services or price estimator requirements (33%).” Dave Muolo, “G.A.O. wants C.M.S. to check whether hospitals’ price transparency data are actually usable,” Fierce Healthcare.
