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Comparative Analysis Between Medicare Payments and Hospital's Published Prices

Announced on  | Last Modified on  | Project Number: OAS-24-07-001
Status
Canceled
Agency
Centers for Medicare and Medicaid Services

OBJECTIVE

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.

TIMELINE

  • September 16, 2024
    Announced
  • November 16, 2024
    Canceled
Work Plan Type
Office of Audit Services
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
Financial Stewardship Hospitals Physician and Healthcare Practitioners
Target Groups
Elderly
Financial Groups
Medicare A