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The Centers for Medicare & Medicaid Services (CMS) issued a Price Transparency Mandate, which requires six thousand hospitals in the US to publish their chargemaster prices in a machine-readable format and 300 shoppable services in a consumer-friendly manner on their websites by January 1, 2021. The requirement is the first step to taking complex healthcare pricing information and making it transparent.

According to CMS, the machine-readable file should include the following:

Comprehensive file with all items, services, and service packages which include:
• Gross charges
• Discounted cash prices
• Payer-specific negotiated charges
• De-identified minimum negotiated charges
• De-identified maximum negotiated charges

A consumer-friendly display that includes the following standard charges for at least 300 ‘shoppable’ services:
• Discounted cash prices (use gross charges if cash prices are not available)
• Payer-specific negotiated charges
• De-identified minimum negotiated charges
• De-identified maximum negotiated charges

or Hospitals can use a patient estimator tool instead of ‘shoppable’ services.

We checked more than 5000 hospital websites to find machine-readable files and patient estimator tools. We analyzed the data to see if the hospitals are compliant with the CMS requirements and simplified the pricing data into a user-friendly format so that anyone can easily understand.

We want to help hospitals that are non-compliant to become compliant using our price transparency innovative Zeatool. Our goal is to help hospitals take this big pricing data, navigate new ways to cut waste, increase revenue, and bring the antiquated healthcare system into the E-commerce age.

Once healthcare data is shoppable, consumers can know the cost of their healthcare services before receiving care. This pricing information is highly beneficial for uninsured, underinsured consumers and self-insured employers to price shop healthcare services.

This report provides an analysis of the Southwest region of the United States.
How Hospitals in the Southwest region comply with CMS Price Transparency Requirements?

We analyzed 689 hospitals in the Southwest Region, found 241 (35%) compliant, and 448 (65%) are non-compliant with CMS requirements. As of March 30, 2021, the non-compliant hospitals will face a penalty of $300/day for a total of $11,961,600 and the penalty for each non-compliant hospital is $25,200.

We analyzed 87 hospitals in Arizona, found 27(31%) hospitals compliant, and 60 (69%) hospitals are non-compliant with CMS price transparency requirements. The 60 non-compliant hospitals will face a total penalty of $1,602,000.

We analyzed 39 hospitals in New Mexico, found 24 (62%) hospitals compliant, and 15 (38%) hospitals are non-compliant with CMS price transparency requirements. The 15 non-compliant hospitals will face a total penalty of $400,500.

We analyzed 122 hospitals in Oklahoma, found 44 (36%) hospitals compliant, and 78 (64%) hospitals are non-compliant with CMS price transparency requirements. The 78 non-compliant hospitals will face a total penalty of $2,082,600.

We analyzed 441 hospitals in Texas, found 146 (33%) hospitals compliant, and 295 (67%) hospitals are non-compliant with CMS price transparency requirements. The 295 non-compliant hospitals will face a total penalty of $7,876,500.

The following ten hospitals have exceeded the CMS requirements by giving Chargemaster MR file, Shoppable Services MR file, and Estimator tools.

ZeaStar Hospitals List

ZeaStar

Sierra Vista Hospital, New Mexico 321300
Mangum Regional Medical Center, Mangum, Oklahoma 371330
Memorial Hospital of Texas County Authority, Guymon, Oklahoma 371340
Wilbarger General Hospital, Vernon, TEXAS 450584
Baptist Beaumont Hospital, Beaumont Texas 450346
Yoakum Community Hospital, Yoakum, Texas 451346
Swisher Memorial Hospital, Trulia, Texas, 451349
Memorial Medical Center, Port Lavaca, Texas, 451356
Winkler County Memorial Hospital, Kermit, Texas, 451314
Comanche County Medical Center, Comanche, Texas, 451382

CMS Price Transparency for Southwest Region USA – PDF


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