Hospital Compliance with Online Dissemination of Standard Charges for Health Care Services – UROP Spring Symposium 2021

Hospital Compliance with Online Dissemination of Standard Charges for Health Care Services

Joshua Agius


Pronouns: he/him

Research Mentor(s): Nicholas Berlin, National Clinician Scholar (Post-Doctoral Fellowship)
Research Mentor School/College/Department: Institute for Healthcare Policy and Innovation, Michigan Medicine
Presentation Date: Thursday, April 22, 2021
Session: Session 6 (4pm-4:50pm)
Breakout Room: Room 14
Presenter: 2

Event Link


In the United States, prices for healthcare services have remained largely concealed from patients. Although patients pay high prices for care that they receive retrospectively, these prices are largely unknown when seeking care initially. For the first time ever, federal Policy CMS-1694-F now requires hospitals to post a list of standardized charges for all health care services online. Although hospital compliance with this policy is essential to achieve its intended purpose, there has not been a comprehensive evaluation into hospital compliance to our knowledge. In this study, we use a cross-sectional survey of a stratified random sample of 500 US hospitals drawn from the pool of 3,451 US general medical and surgical hospitals in the 2018 American Hospital Association Annual Survey. The data collection took place between July 10, 2020 – January 03, 2021. We searched for a list of standard charges posted on hospital websites. If the list was present, we determined if the data was provided in a machine readable format and included the CMS specified shoppable services (evaluation & management services, laboratory & Pathology Services, Radiology Services, and Medicine and Surgery Services). We then looked to see if the list included Diagnosis Related Groups, listings of professional fees and if services were abbreviated. After removing 9 hospitals from our sample that closed or did no longer exist, we determined that 93% of the 491 hospitals in the sample had posted their standard charges. In this sample, however, only 35% of the lists were machine-readable, and 91% of hospitals used abbreviations for their services. The vast majority of hospitals included CMS-defined shoppable services (between 87%-99% for each type of service). In multivariable models, we found that hospitals that were a part of a health system were more likely to provide their standard charges online (odds ratio 3.1, 95% confidence interval 1.5-6.5, P=.003). As CMS considers new federal policies to further improve price transparency for healthcare services, this research allows us to have a much stronger understanding of hospitals’ compliance with price transparency initiatives. Additionally, we can better understand their effectiveness in order to communicate information to policy makers.

Authors: Joshua Agius, Nicholas L. Berlin, MD MPH MS, Zoey Chopra, BA, Arrice Bryant, MPH, Simone Singh, PhD, Paul Schulz, PhD, Brady West, PhD, Jeffrey Kullgren, MD MS MPH
Research Method: Library/Archival/Internet Research

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