How to Comply With (and Exceed) the CMS Hospital Price Transparency Rule Requirements

CMS penalties have dramatically increased in 2022, and providers must take heed before CMS and a legislative gauntlet arrive at their front door.

While it is difficult for many financial managers to accept their negotiated rates being made public, transparency is here to stay in our world and in healthcare. It would be more productive to focus first on complying with the rule and then on how having access to that information can be used to one’s advantage—and how, in this new paradigm, hospitals can find creative new ways to leverage public data. We believe that for those hospitals willing to lead the industry in the world of price transparency, there will be both immediate increased patient satisfaction and imminent future competitive advantages.

Key takeaways from the whitepaper include:

  • Specific requirements of the CMS Price Transparency Rule for both the machine-readable file and the 300 shoppable services in a consumer-friendly display.
  • The different types of consumer displays and patient estimation system solutions to ensure patient satisfaction.
  • Why hospitals should continue to update their chargemasters in a rational and defensible manner, with gross and net revenue modeling considered—but with new consideration given to the selected and complete list of shoppable items.