Turquoise Health raised $40 million in a Series C round to expand beyond price transparency into managing healthcare contracts. The startup’s platform aims to simplify payer–provider agreements, reduce administrative waste and enable patients to see guaranteed upfront prices.
WTW launched the Health Transparency Optimizer to help employers better understand healthcare costs, quality and network options.
Arbiter’s Anjali Jameson on hospital and payer alignment.
In an interview, UberDoc CEO Sean Kearney described how it is carving a niche for healthcare that better serves patients and physicians.
A new Trilliant Health report revealed wide disparities in provider payments, with academic medical centers and certain payer-affiliated clinics receiving far higher reimbursements than their peers for the same services. The findings emphasize just how much opaque pricing practices continue to drive inequities in the U.S. healthcare system.
Health care in the United States is confusing for patients and consumers. Price transparency is a step in the right direction — transformative change can happen by combining cost, quality, appropriateness and efficiency measures.
A new Trilliant Health report reveals vast price variation for identical healthcare services, even for procedures delivered at the exact same facility. Allison Oakes, Trilliant’s chief research officer, urged providers to prove they are delivering true value for the cost and pressed employers to leverage their purchasing power to demand higher-value care.
MedCity News was at the Vive conference and spoke with executives who shared their insights for the healthcare industry.
As an industry, we can and must do more. To be truly actionable, prices must be easily accessible, understandable, and patients need to be actively engaged to act on that information.
For employers to offer effective, accessible and affordable value-based care for their employees, they must address these four components.
In the U.S., many people still struggle to find care, book an appointment, confirm coverage, or get a clear answer on pricing. The impact goes beyond inconvenience, contributing to delayed diagnoses, increased anxiety, and financial stress that harms both patients and the healthcare system.
President Donald Trump’s latest executive order aims to strengthen enforcement for CMS’ price transparency requirements. Some experts think greater price transparency could reduce healthcare costs by fostering more competition, while others are concerned about the potential effects on hospital-payer negotiations, as well as the practicality of enforcing these requirements.
Artera President Tom McIntyre talks about the practical application of AI in healthcare.
Come January 1, CMS will begin enforcing new price transparency requirements for hospitals. Experts doubt that these regulations will do much to help patients shop for care, but they are optimistic that increasing the amount of publicly available pricing data will help tech companies develop tools that simplify pricing for patients.
Dan Reedy, senior director of pricing and underwriting for Abarca, spoke recently with MedCity News about what payers should consider as they explore new models and press for greater transparency.
Elation Health integrated Surescripts’ real-time prescription benefit tool — which gives clinicians immediate access to patient-specific medication coverage and cost data — into its EHR. The partnership aims to improve patients' medication adherence by helping primary care physicians have more meaningful conversations with their patients about prescription affordability during visits.
Most hospitals and payers have publicly posted their pricing information, but experts think that data will remain mostly useless for consumers for at least another five years. Now that the data is available, healthcare software companies must step in and build tools that are personalized and easy to use. That way, consumers can eventually use price transparency data to shop for care.
2024 stands at a critical juncture in the battle against soaring pharmacy costs. In 2023, prescription drug costs rose by 8.4%, a 31% increase from the prior year. Stopping this cost escalation requires restructuring the role of pharmacy benefit managers (PBMs) from multiple fronts. On one front, Congress must pass the proposed legislative reforms that […]