Challenges with Effective Price Transparency Analyses

Promoting price transparency in health care is a policy approach with bi-partisan support in Congress and the public at large, and the first Trump administration finalized regulations that require group health plans and insurers to make detailed data with all their in-network payment rates available with the objective that such transparency would increase price competition and ultimately drive down health care costs.

This report documents how the vast troves of data reported in pursuit of those goals include misleading and unlikely prices, inconsistencies, and other oddities that pose significant challenges for researchers, industry and others seeking to make sense of the data.

The transparency regulations set out in significant detail the methods that payers should follow in reporting their rates, generating huge amounts of publicly available data since reporting began in 2022. The analysis, which relies on the extensive collection of this data downloaded and maintained by Turquoise Health, includes examples about each of the challenges identified and how they complicate efforts to use the data for its intended purposes.

The analysis is available through the Peterson-KFF Health System Tracker, an information hub dedicated to monitoring and assessing the performance of the U.S. health system.