Only 21% of U.S. hospitals comply with price transparency mandate for shoppable imaging exams
In 2019, the Centers for Medicare and Medicaid Services implemented a rule requiring hospitals to publish prices for shoppable services. But new data examining those figures reveals that prices vary widely, and transparency remains lackluster.
The data, published Tuesday in the American Journal of Roentgenology, analyzed prices for four common musculoskeletal imaging exams: contrast-enhanced pelvic CT, unenhanced lower extremity MRI, unenhanced lumbar spine MRI and lumbar spine radiograph.
“Variability in charges for imaging examinations is well-recognized. Greater transparency in healthcare charges could potentially aid patients in predicting and controlling out-of-pocket costs,” corresponding author Matthew B. Petterson, MD, with the Department of Radiology at Standford University, and co-authors wrote.
The doctors used "Newsweek’s Best Hospital’s" rankings to establish the top 250 hospitals in the U.S. They then gathered the publicly available charges for their four chosen musculoskeletal exams and assessed the price variability, ease of access to the chargemaster and the availability of consumer-friendly displays and cost estimators.
They found that all 250 hospitals listed total charges for the four exams within their chargemasters. However, 49 of those hospitals did not offer cost estimators for patients with insurance, and four more did not provide access to charges for consumers who were either uninsured or not current patients at the facility.
Only 21% of the hospitals had all required information available and offered consumer-friendly cost estimators. The doctors noted that the hospitals in total compliance tended to have significantly higher bed counts.
The doctors also pointed to the wide fluctuations in exam pricing. The maximum charge for a contrast-enhanced pelvic CT is listed as $14,238 compared to the minimum charge of $193—a 73.8-fold difference between the two prices for the exact same exam. The significant price variations remained consistent across all four exams.
“Early investigation found widespread noncompliance,” the doctors explained. “The impact of such information on patients’ decisions of where to seek such imaging warrants further investigation.”
Enforcement of the CMS-mandate is scheduled to begin in July 2022.
You can view the detailed data here.
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Wide variation in musculoskeletal imaging charges, including 74-fold difference for one CT exam
Only 21% of U.S. hospitals comply with price transparency mandate for shopable imaging exams
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.