Correlates of Price Transparency for Healthcare Services in United States Hospitals

PURPOSE: The purpose of this study is to investigate demographic and hospital characteristics that predict hospital price transparency in the United States. METHODS: We identified 6214 hospitals and extracted characteristics of each using the American Hospital Association Annual Survey, as well as cash prices for a representative selection of commonly performed procedures and visits from the Turquoise Health dataset. Descriptive statistics were used to determine compliance rates and price variation, and a Poisson regression model was used to calculate incidence rate ratios (IRR) and 95% confidence intervals (CI) for predictors of price transparency. RESULTS: Price transparency compliance ranged from 13% to 49% of hospitals, and across-center ratios ranged from 244.8 to 4789.0. Number of hospital beds was marginally associated with price transparency for more services (IRR: 1.01 [95% CI: 1.01–1.02]); in contrast, location in the Southern (IRR: 0.91 [95% CI: 0.87–0.96]) or Western (IRR: 0.94 [95% CI: 0.90–0.99]) regions of the US was associated with transparency for fewer services. CONCLUSION: Smaller hospitals as well as those located in the South and West regions were less likely to be compliant with the CMS mandate for price transparency for hospital standard charges. Additionally, the poor usability of price transparency directories on hospital websites limits information access and undermines transparency efforts.