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How We Determine Criteria Adherence to OPPS Final Rule

It is important to note that Turquoise Health is not the government-appointed arbiter of price transparency compliance. Only The Centers for Medicare & Medicaid Services (CMS) can deem an organization compliant with requirements. Our intention with reporting on criteria adherence is to share non-biased findings for industry scrutiny. 

OPPS Final Rule Criterion Adherence

The  CY 2024 Hospital Outpatient Prospective Payment System (OPPS) Final Rule includes required schemas for hospital machine-readable files (MRFs) as of 1/1/24, 7/1/2024, and 1/1/25. From new data elements to schema and algorithms, the OPPS Final Rule criteria represent a new facet of what it means for a hospital to be “transparent” with its prices. 

Display Guidelines

Navigating to a hospital’s page, you’ll notice a “Follows CMS Display Guidelines” indicator:

This indicates whether we’ve deemed this hospital to be following the Display Guidelines outlined by CMS  in effect on 1/1/24, 7/1/24, and 1/1/25.

But how are we calculating all of this?

First, we look at the Website we have on file for this hospital. In this case, our Website for HonorHealth Deer Valley Medical Center is: https://www.honorhealth.com/locations/hospitals/deer-valley-medical-center?utm_source=GMB&utm_medium=local&utm_campaign=Valley_Medical_Center

We then strip the link for this hospital down to its root URL. In this case: www.honorhealth.com .

We then add the suffix “/cms-hpt.txt” to the root URL, in search of the required TXT file at it’s correct location. In this case, we’re left with www.honorhealth.com/cms-hpt.txt .

Finally, we ingest this data and map the locations displayed in the file to our database of hospitals. When we find a match, we give the hospital a ✅ indicating that their MRF Location File is present!

For guidance on how to comply with this legislation, you can follow the instructions laid out by CMS.

Adherence to the CMS v2.0 Schema

We will not be displaying adherence to criteria until 7/1/24, when the requirement goes into effect. 

When we do, it will modeled directly after what CMS releases to this link, when available. Stay tuned for updates! In the meantime, if you’re struggling to navigate hospital price transparency compliance, don’t hesitate to reach out with questions!

If you have any questions, or believe we have incorrectly assessed your hospital, please reach out at info@turquoise.health.