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What Hospitals Need To Know About Price Transparency
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Rate Advisor

Rate Advisor

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.
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Contract Concierge

Contract benchmarking, modeling, and measurement through personal consulting with industry experts.
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We utilize extensive proprietary and public data sources to create fact-based, actionable plans to address specific client objectives.
HospitalDx®

HospitalDx®

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.
Check Out The Latest Hospital Finance News!
Monday, July 26, 2021
As new Price Transparency regulations went into effect this year, most hospitals quickly adjusted to become compliant under the new rules. However, many were confused on some points, and some decided not to post their prices, choosing instead to see how CMS would approach enforcement and what, exactly, it regarded as compliance. The new proposed CMS rule (CY 2022 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS-1753-P...
Tuesday, May 11, 2021
Since the passage of the ACA, Price Transparency has largely been a bipartisan issue, meaning that new rules and regulations have appeared, regardless of administration. CMS’ goal is to make it easier for patients to compare prices between hospitals. However, their final rule, which went into effect January 1st, had not yet been followed up by enforcement. CMS’ website claimed they were running audits and reviews of hospital websites, and the industry waited to see if they would start cracki...
Monday, February 15, 2021
The continued pressure on shoppable services has heightened the competition between hospitals and freestanding facilities. But what effect does this have on their day to day business? We analyzed the rate at which hospitals and their freestanding competitors have increased charges in four key groups from 2015 to 2019: imaging, procedures, labs, and therapies and found some interesting trends! The chart below compares U.S. averages from Medicare data for 2015 and 2019. To account for the d...
Thursday, January 21, 2021
Last year the hospital industry faced major changes to the availability and accessibility of their prices. Now that 2021 is here, and the new CMS rules are officially in effect, CMS plans to audit how successfully the industry achieved compliance. According to the CMS website they have already selected hospitals for their initial audits. We’re not sure how hospitals were selected for audits, or what criteria went into CMS’ decisions, but we do know that some of the audits will probe speci...

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