The nonprofit group Patient Rights Advocate just published its fifth report exploring how hospitals are complying with federal price transparency requirements. About two-thirds are still flouting the rules. 

That's unacceptable. Noncompliant hospitals are preventing patients and payers from shopping around for high-value care — and inflating healthcare costs in the process.

The price transparency regulations went into effect in January 2021. Hospitals are now required to publish the prices they have negotiated with each insurer for every service they provide. They must also display the cost of 300 "shoppable" services , such as knee and hip replacements, in a "consumer-friendly" way.

Previously, those prices were secret. Patients and payers had no idea whether a hospital was charging them more than another person or plan. That opacity sheltered hospitals from the sort of cost-deflating competition that exists in every other sector of the economy — and made it easier for them to take advantage of patients and insurers. 

It's one reason why healthcare prices vary so widely across the country. At a hospital in Boston, an MRI might cost a patient between $830 and $4,200, depending on their insurance or whether they're paying out of pocket, perhaps with funds from a health savings account. In Memphis, the same procedure might cost just over $200. 

When patients have access to this pricing information, they can choose a provider that best suits their budget and healthcare needs. That forces providers to compete for patients' business, often by lowering prices. 

Consider the market for laser hair removal. Insurance typically doesn't cover the procedure, so patients have to pay out of pocket. That incentivizes consumers to shop around for the best deal. It's no coincidence that the cost of the procedure fell by 50% between 1998 and 2018.

Of course, hospitals would rather keep their prices high. So, two and a half years on, thousands of them, and many of the largest hospitals, haven't complied with the transparency rules. Seven of the 20 largest health systems have no compliant hospitals, according to the report.

It's long past time they began obeying the law. The federal government should take action to make sure they do.

Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is  False Premise, False Promise: The Disastrous Reality of Medicare for All  (Encounter 2020). Follow her on Twitter @sallypipes .