Post-Gazette Investigation Reveals Widespread Pennsylvania Hospital Noncompliance with Price Transparency Rule

The Pittsburgh Post-Gazette published a 4,000-word investigation into Pennsylvania hospitals’ lack of compliance with the hospital price transparency rule that took effect at the beginning of the year. As the Post-Gazette found:

[N]early seven months after the federal “price transparency” rule went into effect — requiring every hospital in the nation to post the costs of their medical procedures — scores of some of the largest hospitals in Pennsylvania are still failing to abide by a measure that was created to help change health care in America.

A review of Pennsylvania’s 163 acute care hospitals found that about three-quarters are failing to follow the rule, either in whole or in part, creating obstacles for consumers who have long waited to have a greater role in their own medical care.

Hospital prices that have been published show widespread divergences for the same care, reiterating the need for complete hospital price transparency so healthcare consumers can shop for the best care at the best prices:

The data shows that Aetna insurance will pay Allegheny General Hospital $9.45 for a standard blood test but will pay $225.90 for the same test to UPMC Presbyterian-Shadyside.

Cigna insurance will pay Allegheny General Hospital $3,568.78 for a knee surgery, but just a few miles away at West Penn Hospital — part of the same health system, Allegheny Health Network — Cigna pays the hospital $5,859.96.

“What you’ve found illustrates why we need price transparency to work,” Cynthia A. Fisher, founder and chairman of PatientRightsAdvocate.org, told the Post-Gazette. The rule "for the first time allows Americans to actually shop preventably and proactively and take care of their care rather than [risk] facing financial ruin.”

Read the full story here.