Highlights:
- The transparent price puts the patient in control of their financial and medical care decisions. However, many suppliers do not have the right tools to provide precise and initial estimates.
- The February 2025 executive order exerted additional pressure on hospitals to comply with the new medical care regulations and deliver tests to meet the new compliance standards.
- Price Transparency Solutions Help suppliers provide solid estimates, reliable delivery and reports that resist scrutiny.
While the transparency of prices in medical care has improved, it still needs some work. In accordance with the latest data from Experian Health, 88% or suppliers Let’s say there is an urgency to improve or implement precise estimates. Along with The hospital price transparency rule (CMS-1717-F2) that taught effect in January 2025, suppliers also feel the heat of a newly signed Executive order Aimed at strengthening regulations around the transparency of the hospital price, and must take quick measures to meet.
While the total impact of the new executive order is still being defined, now it is the time for health organizations to double in compliance with existing price transparency requirements and obtain the audit. Delivery Price Transparency Solutions It can help hospitals fulfill regulatory mandates, improve patient’s financial experience and keep income cycles on the way.
What is the transparency of health prices?
Transparency of health prices It is the practice of providing clear and initial information to patients about the cost of medical care, including services, tests and recipes.
In February, the president of the United States signed a Executive order Aimed at strengthening the application of hospital prices transparency. For May 26, 2025, three federal departments (health and human services, labor and treasury) must take measures for:
- Requires hospitals and health plans to publish real prices for articles and services (not estimates)
- Make sure the price data is standardized and easy to compare between suppliers and plans
- Improve application and compliance through updated orientation or propose rules
These changes are designed to make medical care prices clearer and more accessible to patients and are based on two existing regulations, the hospital prices transparency rule and NO Str’s law.
He Hospital price transparency rule Its objective is to provide consumers with easy information to prefer hospital prices, train patients to make informed decisions about medical care. In addition, the There is no act of surprises It offers patients protection against surprise billing when certain emergency and non -emergency services are received from suppliers outside the network in the network facilities.
Why transparency of medical care costs is important for patients
Patients want to understand the true cost of care, with 38% or patients To say that understanding the cost of care before treatment made a better payment experience. However, according to Patient access status 202556% of patients say they fight to understand what their insurance covers without the help of their supplier.
Patients also because the most precise estimates. However, despite the increases in patients who receive estimates, precision has unfortunately decreased for the third consecutive year. Without an estimate before treatment, patients are not sure about how much they should and is likely to postpone or cancel care.
How the transparency of costs in medical care improves patient decision making
The patient’s financial trip can be discouraging, especially as medical care costs remain continuous. Today’s patients want to improve access to understand how much attention will cost, verify their budget and calculate if they can pay the cost. Often they also want to know the cost in advance to compare the costs, have time to save the invoice or explore the payment options.
Cost transparency places patients in the driver’s seat. When suppliers send precise, transparent Patient estimates In advance, patients are empowered to make more informed financial and health decisions. Patients also want to understand their financial responsibility after insurance, with 77% of patients To say that it is important that your supplier can explain what your insurance covers before treatment.
Besides, 81% of patients Also report that precise estimates help them to prepare better to pay their medical bills. This can lead to patients obtaining the attention they need to postpone it due to unknown costs.
Benefits of hospital price transparency for suppliers
Failure to comply with price transparency regulations can lead to fines and public notices that affect their reputation. With the approval of the new executive order, the Medicare and Medicaid Service Centers (CMS) are increasing the application of Price Transparency Regulations. In the first two months of 2025 alone, More actions They were tasks that in all 2024.
Medical care organizations with current price transparency tools will be in a solid position to comply with current regulations and whatever comes later.
Price transparency It also comes with financial benefits, as a greater opportunity for Fast patient paymentsthat can help keep income cycles on the way. According to Experian Health data, 38% of patients reports that understanding the cost of care before treatment was for a better payment experience. When patients can pay their bills as a whole or through a payment plan, suppliers spend less time chasing collections. More charges in time help suppliers to maximize income, avoid income leaks and minimize the potential of uncollectible debt.
The role of price transparency tools in the health system
The regulatory requirements on prices transparency are quickly evolving. Price Transparency Tools It helps hospitals to keep fulfilling, improving the patient’s financial experience and reducing the administrative load for occupied personnel.
Tools like him Patient estimates From Experian Health and Cleverly + Associates offer the following benefits:
- More precise estimates: Experian health Patient estimates The solution generates real -time estimates using the most up -to -date payer contracts, rates schedules and historical claims data.
- Audit protection: estimates the patient It includes four incorporated reports to align estimates with reais, monitoring collections and demonstrate compliance, so hospitals are always ready for the audit.
- Improved workflows: Efficient solutions that simplify the estimated delivery, reduce estimated errors and scales easily to replace manual processes that require a lot of time and disjointed delivery systems.
- Improved access to the estimates: TO Self -service portal It allows patients to conveniently access personalized estimates. Hospitals can also use complementary tools, such as Patient Financial Advisorto text estimates to patients or download a PDF estimate in the office. With this solution, some clients have reported a direct correlation between the automated estimate delivery and collection increases in almost 133%.
Move towards a more transparent health with Experian Health
Experian Health undertakes to develop solutions that strengthen the transparency of prices in medical care. Through an association with Cleverley + Associates, Experian Health makes it simpler for hospitals to comply with price transparency regulations and help patients understand the cost of care.
Learn how Price Transparency Solutions From Experian Health and Cleverley + Associates they can help the ORI.