Five Considerations for Turning Transparency into Value

How prepared is your organization to operationalize price transparency data?

Explore these five considerations from our team of experts.

Price transparency alone does not lower costs. Meaningful impact comes from applying normalized, contextualized data to decisions such as contracting, network design, and member steerage.

Regulatory focus is evolving from simply publishing data to making it usable. Increased enforcement, more frequent machine-readable file (MRF) updates, and proposed legislation such as the Patients Deserve Price Tags Act are accelerating that shift.

Hospital and payer files vary widely in structure, timing, and methodology. Organizations must normalize rates, such as comparing base rates versus all-in amounts, before benchmarking costs or making network decisions.

Expanding transparency requirements to ambulatory surgery centers, labs, and imaging facilities could create greater opportunities for steerage to lower-cost settings and improve confidence in savings strategies.

More mature transparency strategies pair utilization data with machine-readable file insights to support network negotiations, evaluate leased networks based on allowed amounts instead of discounts, and assess adequacy at both the market and provider levels.

New ideas, proven best practices, and fresh perspectives for the healthcare ecosystem.

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