Beginning in July 2022, three phases of US health plan price transparency regulations will become effective, extending existing rules for hospitals that were implemented on January 1, 2021. Price transparency rules intend to make consumers aware of the cost of the covered item(s) or service(s) before receiving care, so they are empowered to shop for the healthcare that best meets their needs. The concept of price transparency has broad support, but its implications across hospitals and health systems (providers), health plans, self-insured employers, and consumers require some reflection.

Dr. Sandesh Prabhu from HCL Technologies and Rohan Kulkarni from HFS research  have co-authored a PoV on the new US health plan price transparency regulations and their impending effects on not only health plans and patients but also on providers and self-insured employers.

Key takeaways

• The industry is affected and might respond over the short term, medium-term, and long term, as health systems are mandated to share price information for all items and services
• Price transparency will affect the transition to value-based care for health systems and health plans
• Patients gain access to more choices than ever before and shop for the best healthcare available
• Providers, health plans, self-insured employers, and consumers adapt to operating in an increasingly integrated health ecosystem
• Service providers integrate blockchain, AI, analytics, and more into solution offerings to cater to a dynamic value chain

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