
Healthcare Price Transparency is More Than Showing a Price Tag
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.
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.
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.
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 […]
Turquoise Health closed a $30 million Series B round, which brings its total funding to date to $55 million. The San Diego-based startup, which has more than 160 customers, sells a platform that makes it easier for hospitals and payers to comply with price transparency regulations.
Break down the silos. Take control of your provider data.
The word has gained greater urgency in recent years as the consumer trend in healthcare has forced payers, providers and all other kinds of healthcare stakeholders to swear by it.
Hospitals markedly improved their compliance with price transparency regulations in 2023, according to a new report. It found that more than 90% of hospitals have posted a machine-readable file containing gross charges, negotiated charges and cash prices for the services and items they provide.
The mandates set the framework and data requirements for transparency but consumers need more guidance for informed decision-making and comparisons. Health plans should be acting now to turn the conversation from compliance to true member engagement.
During the first three quarters of 2023, the prices for CMS’ 500 shoppable services increased by 2.0%, according to a new report. This figure is in alignment with the 1.9% U.S. inflation measured by the Personal Consumption Expenditures Price Index and below the overall U.S. inflation rate measured by the Consumer Price Index.
The Lower Costs, More Transparency Act has passed in the House with bipartisan support. The action is being applauded from several advocacy organizations.