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Abstract

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Background:
Healthcare price transparency laws now enable disclosure of negotiated rates between hospitals and payers. However, clarity is lacking on how different commercial insurers compare in that transparency. This article examines how effectively four national commercial payers disclose pricing information, exploring variation and gaps in transparency.

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Methods:
The study analyzes publicly available hospital pricing data under the Hospital Price Transparency Rule (effective as of early 2023) for four prominent national commercial insurers. It assesses the completeness of disclosure, range of services reported, and consistency in presenting negotiated rates in a machine-readable format.

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Findings:

• Significant variation exists across the four payers in both the breadth of services disclosed and the structure of data presentation.
• Some payers provide more comprehensive, standardized, and easy-to-use files; others deliver fragmented or poorly formatted disclosures.
• These inconsistencies hinder meaningful comparisons for consumers, researchers, employers, and policy analysts seeking to understand pricing differences across insurers and markets.

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Conclusions:
Although transparency rules have improved access to data, meaningful comparison of prices across commercial payers remains limited by disparities in how the data are shared. To enhance transparency, the article recommends:

1. Improving data standardization across insurers (consistent formatting, complete service lists).
2. Expanding the scope of services disclosed.
3. Adopting best practices from more transparent payers.

These steps are needed to maximize the potential of price transparency to drive fair competition and enable empowered decision-making.

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Full Article: https://www.healthaffairs.org/content/forefront/commercial-insurer-price-transparency-comparison-four-national-payers

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