Price Transparency Regulations
Dec 2020
Consolidated Appropriations Act of 2021
Amended ERISA to require employer-sponsored health plans to ensure fiduciary responsibility fulfillment.
2021-2024
Hospital Price Transparency Rules
Requires hospitals to publish pricing data and a Patient Estimate Tool.
2022-2025
Transparency in Coverage (TiC)
Requires payers to publish pricing data and a Patient Estimate Tool.
2022-2027
No Surprises Act (NSA)
Requires accurate, up-front Good Faith Estimates and Advanced EOBs.
Price transparency data is the new, dynamic UDS
UDS
Broad discounts data
Limited to 3-digit zip code
Doesn’t pair well with claims data
Limited and opaque
18-24 months lag
Price transparency data
Granular data
Network, provider, and code specific
Pairs well with claims data
Actual reimbursement data
15-30 day lag
Featured Content
Can Price Transparency Replace UDS Data for Brokers?
Let’s take a look at the new kid on the block
Reimbursement Structure Trends & What They Mean for Providers
Let’s add “business intelligence" into the Price Transparency Cinematic Universe.
Studies show price transparency is demystifying the healthcare market
From trauma centers to costs at large, we’re seeing things we’ve never seen before. Literally.
Healthcare pricing is laughably complex.
It doesn't have to be.
