A report by a patient advocacy group finds that only 16% of U.S. hospitals are complying with a federal rule that requires them to provide clear and accessible pricing information online about services.

The Hospital Price Transparency rule, which took effect in January 2021, requires hospitals to provide that information in two ways: As a comprehensive machine-readable file with all items and services; and a display of shoppable services in a “consumer-friendly format.”

The report by Patient Rights Advocate published in August reviewed 2,000 hospitals across the country and found that 319 were complying with the rule.

“Only 16% of the nation’s hospitals are in compliance with this law, essentially keeping patients still blind to new prices, able to be blindsided by overcharged bills,” said Cynthia Fisher, founder of the Patient Rights Advocate.

Federal agencies say that by promoting price transparency in health care, it will help increase market competition, and ultimately drive down the cost of services, making them more affordable for patients.

“I think the consumers need much, much more than just price transparency,” said David Blumenthal, president of Commonwealth Fund. “Price transparency is the first step on a long journey toward functioning health care markets, if that is ever going to be possible.”

Sandra Washington, a board certified patient advocate of Medi-Helpz LLC based in Chicago, encourages patients to use their voice in navigating the health care system.

“Call your insurance company, speak to your insurance company reps,” Washington said. “A lot of insurance companies already were listing their information on their website, it’s just that a lot of patients didn’t know where to go get that information.”