Hospital compliance with price transparency policy in the U.S.

Background: Starting in 2021, U.S. federal regulations required hospitals to disclose their prices and negotiated third-party payor rates as well as publish chargemasters and pricing information for 300 shoppable healthcare services in a consumer-friendly manner. There is variation in hospital compliance with this policy. The purpose of this study was to report the level of hospital compliance and examine factors associated with compliance so as to promote consumer-friendly hospital pricing information disclosure. Methods: Our study used data collected by ZeaMed Health from January to October 2021 and linked it to the 2020 American Hospital Association (AHA) Annual Survey data. We focused on non-federal hospitals in 50 states and Washington, D.C. The total analytical sample size was 4,910 facilities. We conducted bivariate and multivariable logistic regression to analyze associations of market competition and hospital characteristics with hospital price transparency compliance. Results: Our study found that only 33.40% of hospitals were in compliance with price transparency regulations. Hospitals that were part of a centralized physician/insurance, moderately centralized health system, critical access hospitals (CAHs), and sole providers had higher odds of compliance. On the other hand, hospitals affiliated with a decentralized health system as well as non-profit/public hospitals had lower odds of compliance. The level of market competition was not associated with hospital compliance with the regulation in our multivariable logistic regression analysis. Furthermore, the results showed that compliance was higher in certain geographic regions. Conclusions: Further policy implementation efforts should be directed towards assisting non-system affiliated hospitals, non-critical access/non-sole provider hospitals, non-profit/public hospitals, and geographic regions with low compliance rates.