Comparative Analysis Between Medicare Payments and Hospital's Published Prices

CMS issued a final rule (effective January 1, 2021), to improve transparency in health care costs by requiring hospitals to make their prices readily available for consumers (the Hospital Price Transparency (HPT) rule). CMS believes that the Hospital Price Transparency (HPT rule) will increase market competition and drive down the cost of health care services. One of the requirements of the HPT rule is for hospitals to make public all negotiated charges with third-party payers. We will examine and conduct an analysis to compare the pricing information published by the hospitals to the amounts that Medicare paid. Specifically, we will evaluate how much Medicare pays in comparison to the third-party payer negotiated charges and the minimum negotiated charges.

Announced or Revised	Agency	Title	Component	Report Number(s)	Expected Issue Date (FY)
September 2024	Centers for Medicare and Medicaid Services	Comparative Analysis Between Medicare Payments and Hospital's Published Prices	Office of Audit Services	OAS-24-07-001	2026