As of January 2021, hospitals are required to comply with price transparency requirements issued by the Centers for Medicare & Medicaid Services (CMS). These requirements include posting a machine-readable file containing payer-specific negotiated rates and a second file with at least 300 shoppable services.
In a presentation at the Ohio Rural Health Conference, PYA Principal Bob Paskowski, Director of Business Intelligence & Analytics Jason Hardin, and Senior Manager Kathy Reep addressed the new penalties for non-compliance and examine common errors providers have made in posting the files. And, as more and more providers are posting their data, they discussed how hospitals are using that information in benchmarking negotiated rates.
The presentation, “Price Transparency–Using the Data,” provided:
- A review of the CMS requirements related to the posting of rates.
- Insight into identified errors in the current data.
- Insight into hospitals’ negotiated charges for their contracted payers.
- Examination of the variation in pricing for similar healthcare services.
- A look at PYA’s new “Negotiated Pricing Dashboard” to share the utility by hospitals.
The event took place Aug. 1-2, 2022, in Cambridge, Ohio.
View the presentation slides here.
If you would like assistance with price transparency issues, or any matter involving compliance, valuation, or strategy and transactions, one of our executive contacts would be happy to assist. You may email them below, or call (800) 270-9629.