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Healthcare providers concerned, unsure how to address CMS price transparency final rule

There is growing concern about how much value the rule really provides for patients and the potential perception problem it creates for hospitals.

Jeff Lagasse, Associate Editor

Almost all healthcare providers -- 92 percent in total -- are concerned to some degree about how their charges will be perceived by the public in response to the Centers for Medicare and Medicaid Services' price transparency final rule, according to a survey of 150 healthcare participants on a recent webinar with PMMC Healthcare Business Insights.

The participants varied in size, ranging from hospitals with 100 acute care beds to multi-facility healthcare systems.

The webinar addressed the frequently asked questions from the CMS price transparency final rule, highlighting the fact that hospitals must post standard charges online for any given service in a machine-readable format.


There is growing concern about how much value this really provides for patients and the potential perception problem it creates for hospitals.

Despite the January 1, 2019 deadline for the rule, 43 percent of healthcare providers responded that they don't know yet how they will address the mandate. Twenty-nine percent said they plan to post additional pricing information beyond the chargemaster, while 22 percent said they would post chargemaster prices only.

Despite the vague guidelines provided by CMS, it's become apparent that the agency is pushing the healthcare industry towards a retail-like model to help consumers price shop for healthcare services.


Patients are price shopping online today more than ever. According to the 2018 UnitedHealthcare consumer sentiment survey, 36 percent of respondents said they have used the internet or mobile apps during the past year to compare the quality and cost of medical services. This is almost triple the amount since 2012, when only 14 percent of patients were price shopping.


Only one in 10 patients said they would actually switch healthcare providers after price shopping.

Because patients rarely pay the full listed chargemaster price, hospitals posting just the standard chargemaster run the risk of misleading patients into inaccurate pricing.

Another concern is that the rule won't work from the standpoint of CMS promoting price transparency. Patients will be able to see the chargemaster "rack rate" of what a service costs, but will still have no better idea of what they'll end up paying.


It's important for hospitals to consider a more strategic approach when posting the chargemaster and making it easier for patients to price shop by presenting a personalized cost of care. This allows the hospital to control the price message and will prevent patients from potentially visiting a different provider in favor of a better price.

Twitter: @JELagasse

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