We analyze hospital prices at the procedure code level and present an analysis of suggested rate changes designed to enhance the defensibility of proposed pricing with sensitivity to financial impact.
Web-based software that creates custom analyses of financial/operating strengths, weaknesses, and opportunities. Utilizes client-submitted claims data as well as national public-use data.
Patient Rights Advocate Dramatically Overstates Hospital Non-compliance
Last month, PatientRightsAdvocate.org (PRA) released its Sixth Semi-Annual Hospital Price Transparency Compliance Report (https://www.patientrightsadvocate.org/semi-annual-report-feb2024). The report shows that 34.5% of the 2,000 US hospitals it reviewed comply with federal price transparency requirements. Unfortunately, PRA’s findings continue to be horribly flawed. HFMA, AHA, and even CMS have countered the findings in ...
Cleverley + Associates Looks at the Link Between Value and Hospital Price Transparency
On January 18th of this year Money Magazine released its list of Best US hospitals. They provided 5 overall metrics for each of the top US hospitals: Overall Grade (A+ to B), Top Specialty, Price Transparency (A+ to D-), Top Service, and Federal rating. They explained their methodology for determining the overall rank as follows:
“Our first step to whittling down 6,000-plus hospitals across the country was ...
Are Health Insurance Firms Putting Profits Over Patient Care?
There have been some advertisements on various media platforms suggesting that major health insurance firms are prioritizing profits over the health of patients. The website that contains more information is www.healthcomesfirst.org and is an initiative of Trinity Health. The primary focus of the commercials and the website is that hospitals are not being fairly reimbursed by major health insurance firms and are realizing inadequa...
What’s New in Hospital Price Transparency and How Did We Get Here?
The CY24 OPPS Final Rule contains additional information and requirements regarding hospital price transparency. The changes build on transparency requirements previously established in past rules and other regulations.
In 2010 the ACA responded to calls for price transparency.
In 2014 the FY15 IPPS proposed rule called for hospitals to make pricing available to the public by posting the CDM information or provid...