Policy Examples

• Effective January 2019, CMS requires hospitals to publish their retail charges for healthcare services. CMS has proposed a rule requiring hospitals publish their gross charges and the negotiated price by specific payer and plan for a set service. source
• Seven states have laws currently requiring hospitals to publicly list prices, with New Hampshire being the only state posting prices online. source

Outcome Evidence

• In 2014, consumers and patients who used Castlight Health’s online pricing platform saw a significant decrease in certain aspects of their healthcare spending. source
• A study utilizing Massachusetts insurance data published by Northwestern University found that consumers will opt for lower price inpatient care when presented with clear and simple information. source
• A 2016 Robert Wood Johnson national survey of American adults found that a majority have attempted to find information on the cost of care before receiving the services but are generally uninformed on important information. source
• A 2016 study published in a Health Care Financing and Organization (HCFO) brief examined a large health plan’s customized price transparency tool that provided bundled total and out-of-pocket costs over the course of an episode for selected conditions. The study found only a small number of those with access to price information used the information. source
• The HCFO published a study in 2016 which used a price transparency tool with a relatively healthy, educated population employed by a large health care information technology firm and enrolled in high-deductible health plan options. The study found utilization of the tool was not associated with lower healthcare costs. Over 50% of employees with access to the tool used the tool only once and 10% of employees used it three times or more. source