Price Transparency Rule for Hospitals Case Study

Overview

Bureaucracy often dictates rules and regulations. For example, to help consumers compare prices across hospitals and estimate the cost of care, the Centers for Medicare and Medicaid Services (CMS) published rules governing hospital price transparency. Hospitals are required to provide clear, accessible pricing information online about the items and services they provide in two ways:

As a comprehensive machine-readable file with all items and services

In a display of shoppable services in a consumer-friendly format

• Noncompliance with the mentioned transparency rule may lead to the penalties and other legal actions defined by CMS.
• This assignment will help you understand how bureaucracy plays an important role in forming and reforming the rules. Also, it will support your project work by helping you understand how policies and new rules impact stakeholders.

Prompt

Write a short paper focusing on the current hospital price transparency rule. Your research should include the rule enforcement strategy, how hospitals are complying with the rule, and the impact of this rule on the healthcare system.

You must cite at least three sources to support your claims. For additional help with completing this assignment, refer to the Shapiro Library Guide: Nursing – Graduate item in the Start Here module. You may also use the Online Writing Center, located in the Academic Support module.

Specifically, you must address the following rubric criteria:

Rule Enforcement Strategy: Explain the bureaucratic strategy CMS is using to enforce the price transparency rule for hospitals.

Legal Risks and Liabilities: Describe the legal risks and liabilities associated with the price transparency rule for hospitals, including how to differentiate between legal risks and liabilities associated with this rule. Consider the following questions in your response:

What are the penalties and other legal actions defined by CMS for noncompliant hospitals?

1. Hospital Compliance Preparation:Describe how hospitals need to prepare in order to comply with the rule of price transparency. Consider the following questions in your response:

What are the guidelines for displaying standard charge information?

1. How does the rule of price transparency apply to federally owned or operated hospitals (such as a Department of Veterans Affairs hospital)?

How can this price transparency rule be improved to help people with low or no internet access?

Impact on Overall Healthcare System: Hypothesize the potential effects of the price transparency rule on the overall healthcare system. Consider the following questions in your response:

• What are two potential drawbacks of this rule for privately owned hospitals?

1. What are two potential benefits of this rule for federally owned hospitals?