ARRS 2022 Abstracts

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E1779. CMS and Calculators: Hospital Price Transparency Requirements and Imaging Cost Variability
Authors
  1. Matthew Petterson; Stanford University Department of Radiology
  2. Marc Willis; Stanford University Department of Radiology
  3. Robert Boutin; Stanford University Department of Radiology
Background
The Centers for Medicare and Medicaid Services (CMS) rule on hospital price transparency, intended to empower patients through better access to price information, went into effect in early 2021. Hospital systems have complied by making price information publicly available, though with heterogeneity of the clarity and accessibility of the published information. With enforcement slated to begin in 2022, awareness of the CMS requirements is necessary.

Educational Goals / Teaching Points
This exhibit will introduce the CMS hospital price transparency requirements, including the types of charges that must be made publicly available; discuss variability in the accessibility of published price information for the layperson; and illustrate the marked heterogeneity in pricing of common imaging examinations within a major metropolitan area and across prominent U.S. academic medical centers.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The new CMS rule, “Price Transparency Requirements for Hospitals to Make Standard Charges Public,” requires hospitals to publish gross charges, discounted cash prices, as well as charges negotiated with third parties. In addition, hospitals must publish a consumer-friendly list of 300 “shoppable services,” which includes 70 services specified by CMS. Efforts to meet these requirements have had a mix of easily accessible and relatively opaque results for the medical layperson. At this point in time, early in disclosure of price information, there is marked heterogeneity in the cost of common imaging examinations across major hospitals in a major U.S. metropolitan area and across prominent U.S. academic medical centers, with some common imaging exams varying 3500% in price between hospitals.

Conclusion
The new CMS rule has created an opportunity for radiologists to support efforts to clearly disclose accurate and layperson-friendly price information. Given the potential for prices to shift in response to market forces following public price disclosures, radiologists must be prepared for changes in the financial landscape.