Publishing the real prices that hospitals negotiate with insurers is not just a paperwork exercise. A new nationwide analysis co-authored by Memorial Sloan Kettering and Turquoise Health finds that when hospitals fully disclose what they charge for cancer care, commercial prices tend to drop, in some metro areas by more than 8 percent. The study tracks how negotiated rates shifted after the federal hospital price transparency rule took effect and compares markets where more hospitals posted complete pricing data with those that did not. For patients and employers, the takeaway is that clearer price tags can nudge the market toward lower bills for certain oncology services.
Study methods and headline results
The peer-reviewed analysis, published in Value in Health, pulled machine-readable price files and commercial negotiated rates for oncology services from December 2021 through June 2024. The authors examined 89 billing codes across 228 hospitals and found that every 10 percentage point improvement in code-level transparency was associated with a 0.82 percentage point annual decline in negotiated rates. In cities where most hospitals posted complete pricing files, oncology prices fell by as much as 8.2 percent.
What this looks like for New York
In New York, the results land in a market where transparency is still a work in progress. Turquoise Health’s data, as reported by Crain’s New York Business, show that roughly 64 percent of hospitals in the state meet two core Centers for Medicare & Medicaid Services disclosure requirements. That leaves plenty of gaps that make it harder for patients or employers to comparison shop for cancer care. Memorial Sloan Kettering, the Upper East Side-based cancer center that helped produce the research, is among the institutions included in the analysis, giving the paper a direct New York angle.
Data quality is the sticking point
The study’s Turquoise Health researchers caution that “data quality really matters,” because inconsistent file formats, missing fields, and other quirks make apples-to-apples comparisons difficult, according to Crain’s New York Business. Federal watchdogs have echoed the concern. A U.S. Government Accountability Office review found that CMS lacks assurance that hospitals’ posted pricing data are complete and accurate, which undercuts the consumer and market value of the disclosures.
Policy context and enforcement
The Centers for Medicare & Medicaid Services began rolling out the hospital price transparency rule in January 2021. Hospitals must now provide both a comprehensive machine-readable file and a consumer-friendly display of shoppable services. As Centers for Medicare & Medicaid Services explains, the rule is meant to help patients estimate costs in advance, but regulators and researchers say that stronger standardization and cleaner data are needed before the full savings described in the new study can be realized.
For New Yorkers, the bottom line is cautious but hopeful. The Value in Health paper offers early evidence that when more hospitals come clean on their prices, commercial cancer costs can edge down and the gap between high-priced and low-priced hospitals can narrow. How far that trend goes will depend on whether hospitals improve the completeness and quality of their data and how quickly laggards catch up on compliance so that patients can actually rely on the numbers in front of them.
