Texas hospital price transparency compliance doubles
Dec. 7—AUSTIN — Texas 2036's online dashboard, which displays health care pricing data in an easy-to-visualize format, shows that a majority of Texas hospitals — twice the percentage from the spring — now provide pricing data in compliance with transparency laws, a press release stated.
Both federal rule and state law require all Texas hospitals to post data on their website that details the costs of their services, including the negotiated rate for each insurance payer. These requirements have been in effect since Jan. 1, 2021.
As of our evaluation in October 2022, most hospitals in Texas were in compliance. Of note:
>> Texas 2036 was able to access data for 86% of hospitals (out of 648 statewide).
>> 60% of hospitals were "mostly compliant" with federal and state requirements, which is our evaluation's highest rating. This is nearly double the rate from our Spring evaluation, when one-third of Texas hospitals were found to be "mostly compliant."
>> Some Texas hospitals posted files that missed key pieces of data, such as insurer-specific rates.
>> The availability and formatting of hospital codes and insurer-specific information make data harmonization and comparisons between hospitals difficult and, in many cases, impossible.
Texas 2036 began researching this data to evaluate the actual prices paid by insurers and patients for various health care services around the state. Texas 2036's interactive dashboard provides users the ability to see the data statewide by Public Health Region, Senate District, Largest Hospital Systems, and Individual Hospitals.
"Our latest analysis shows that Texas hospitals — especially some of our largest systems — have made great progress, with most achieving compliance," Charles Miller, senior policy advisor at Texas 2036, said in a news release. "At the same time, it shows that there is work yet to be done by a minority of Texas hospitals to get up to compliance with federal and state requirements that have been in effect for nearly two years."
The public dashboard, which can be found at pricetransparency.texas2036.org, represents the most comprehensive, publicly available Texas health care pricing transparency tool. It analyzes pricing data for a range of health procedures and services, both statewide and within 11 Public Health Regions — providing Texans a snapshot of how prices for the same health care services vary among hospitals, payers and geographic regions.
The evaluation scores range from "no website" to "mostly compliant."
"Mostly compliant" is the highest score that Texas 2036 can issue. This rating does not indicate that the analysis identified areas where a hospital was not in compliance, but instead, it reflects that Texas 2036 lacks the capacity a government would have to independently verify that a file is "fully" compliant with certain aspects of the law.
For example, Texas state law requires hospitals to include prices for all services that they offer in their transparency file. Because Texas 2036 does not have access to publicly available lists of all services offered at each hospital, we have been unable to confirm that all services offered at a hospital are included in their price-transparency file.
As part of an ongoing effort by federal agencies to empower employers and consumers to make more informed decisions about their health care spending, federal rules required hospitals operating in the United States to provide clear, accessible pricing information about their services beginning Jan. 1, 2021. Texas passed a similar law that went into effect in September of that year. Most insurers and employers were required to disclose their own transparency files as of July 1, 2022. Beginning in 2024, they will be required to provide their enrollees with consumer-friendly comparison-shopping tools that show consumers' out-of-pocket costs for specific providers.
