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Health care economists argue hospital mergers can raise costs and lower quality. And now, a new study adds another downside: Hospitals in concentrated markets are also less likely to be transparent about their prices.

Researchers pored over the websites of more than 5,200 hospitals to check on their adherence to the federal Hospital Price Transparency Final Rule, which took effect in January 2021. Their research letter, published Tuesday in the Journal of the American Medical Association, shows compliance is dismally low — less than 6% — adding to previous research and media reports that found the same.

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But this new study has an important twist. It shows hospitals located in highly concentrated markets — those where fewer hospitals dominate — are less likely to comply with the rule, which requires hospitals to publish the rates they’ve negotiated with insurers. Conversely, hospitals in markets with a lot of competition are more likely to comply.

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