Hospitals using computer coding to skirt transparency rules, WSJ investigation finds

Hospitals are complying with a regulation requiring them to publish prices, but good luck finding it with a Google search.

Federal officials who developed the price transparency rule said the data could help consumers find better deals and help doctors and employers select the hospitals where they steer patients for service. (Image: Shutterstock)

Hospitals are evading the spirit of new price transparency regulations while technically following the letter of the law, a “Wall Street Journal” investigation has found.

Hospitals that have published their previously confidential prices also have blocked that information from web searches with special coding embedded on their websites. The information must be disclosed under a federal rule aimed at making the $1 trillion sector more consumer-friendly. However, hundreds of hospitals embedded code in their websites that prevented Google and other search engines from displaying pages with the price lists, according to an examination of more than 3,100 sites.

Related: How benefits brokers are preparing for new health care transparency rules

“It’s technically there, but good luck finding it,” said Chirag Shah, an associate professor at the University of Washington. “It’s one thing not to optimize your site for searchability; it’s another thing to tag it so it can’t be searched. It’s a clear indication of intentionality.”

Among websites where researchers found the blocking code were those for some of the biggest U.S. health-care systems and some of the largest hospitals in cities, including New York and Philadelphia. They include hospitals owned by HCA Healthcare, Universal Health Services Inc., the University of Pennsylvania Health System and NYU Langone Health.

Hospitals are supposed to disclose price information that they have long kept secret to comply with a federal rule that took effect Jan. 1 as part of a Trump administration push to increase transparency in health-care pricing. For the first time, the rule is revealing the prices that insurers negotiate for many hospital services. Federal officials who developed the regulation said the data could help consumers find better deals and help doctors and employers select the hospitals where they steer patients for service.

The use of blocking code is one way hospitals have fallen short of the rule’s requirements, experts on the new regulation said. “They’re taking an active step to make something harder to find,” said Thomas Barker, a health-care attorney at Foley Hoag and former official at the Department of Health and Human Services. “I would say it violates the spirit of the rule.”

The rule requires hospitals to release prices for all services. Hospitals typically have a sticker price, which can be a starting point for discounted rates they negotiate with insurers. Hospitals also have cash prices for the uninsured. The new regulation requires disclosure of those rates, in addition to the insurers’ prices. The rule also says that the data file with all of the rates has to be displayed prominently on a public website and that a hospital has to ensure the data “are easily accessible and without barriers.”

“We expect hospitals to comply with these requirements and will enforce these rules to make sure Americans know the cost of their health care in advance,” an HHS spokesman said.

Read more: