Hospitals with higher consumer ratings are more likely to comply with imaging price transparency initiatives, according to new research published in the Journal of the American College of Radiology.

It’s been more than a year since the Centers for Medicare & Medicaid Services started requiring providers to publicly post prices for 300 “shoppable” services. As of last fall, 49.5% of hospitals were compliant with the mandate, Neiman Health Policy Institute experts detailed Feb. 18.

Those with better patient-recommendation star ratings (as measured by HCAHPS) had higher compliance rates (odds ratio of 1.7) with the federal mandate. Researchers also unearthed wide variation in charges and cash prices for lumbar spine MRI, with as high as 50-fold differences from one hospital to the next.

“Our data suggest that eight months after the CMS price transparency mandate, only half of hospitals offering lumbar spine MRI were compliant,” Gelareh Sadigh, MD, with the Department of Radiology and Imaging Sciences at Atlanta-based Emory University, and colleagues wrote. “Since CMS recently increased its $300 daily monetary penalty for noncompliance to $5,500, future studies are necessary to assess whether this higher amount of penalty will facilitate higher hospital compliance,” they added later.

For their study, Sadigh et al. manually searched the websites of all hospitals listed in the Medicare Hospital Compare Quality of Care database. They pinpointed those with publicly available OP-8 scores—a CMS imaging quality metric denoting the annual percentage of patients receiving lumbar spine MRI for back pain in an outpatient setting. Researchers determined compliance with the price transparency rule by assessing the online availability of a chargemaster, consumer friendly list of 300 shoppable services/price estimator tool, and listed cash price for lumbar spine MRI.

Altogether, 523 hospitals met the study’s criteria. Those with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings of 4 or 5 were 70% more likely to be compliant with the price transparency mandate. Meanwhile, institutions with higher Google star ratings had higher cash prices for imaging, the authors found.

“Our results suggest that hospitals that are focused on the patient experience are more likely to comply with price transparency, a patient-centered initiative,” first author Richard Lin said in a statement.

Read more about the results in JACR, and you can check out a similar study from some of the same authors here.