Should Healthcare Pricing Be More Transparent?

 

Healthcare prices have continued to rise in the United States in recent years, and no solution has been agreed upon. Making a complicated situation even hard to solve is the fact that the supply chain is much more complex in healthcare than in the exchange of other goods and services.

One of the major qualms about healthcare pricing is its lack of transparency. The negotiated rates between pharmaceutical companies and hospitals, insurers and pharmacies are private. This seemingly makes it difficult for consumers to shop around for lower prices.

A new executive order signed in June calls on the Department of Health and Human Services to force these negotiated rates to be publicized. This is designed to increase transparency of price and create market competition. Ideally, this will lower prices for consumers, but consensus has is hard to come by on the topic.

“Some states have already passed price transparency laws, like New Hampshire and some others, and again the story isn’t that great, at least the evaluation suggests they haven’t made an enormous impact or any impact at all on prices,” Mark Pauly, a professor of healthcare management at the Wharton School of Business at the University of Pennsylvania said.

Industry insiders are unsure of the impacts this transparency will have. Due to the nature of insurance and the way drug prices are established, transparency may not yield true competition, according to Pauly.

“You can’t look up in the Wall Street Journal, ‘what’s the going price today for a hospital day or a doctor visit’,” Pauly said. “These things are negotiated and typically the market structure for hospitals is one of oligopoly, with just a few hospitals in a typical town.”

The executive order did not spell out specifics but asked HHS to develop a policy that increases transparency.

For the latest news, videos, and podcasts in the Healthcare Industry, be sure to subscribe to our industry publication.

Follow us on social media for the latest updates in B2B!

Twitter – @HealthMKSL
Facebook – facebook.com/marketscale
LinkedIn – linkedin.com/company/marketscale

Follow us on social media for the latest updates in B2B!

Image

Latest

network innovations
Network Innovations
May 22, 2025

Brent speaks with Day-Vene Gilliam, VP of National Network Optimization & Business Development at Elevance Health, about how Anthem is evolving its network strategy to deliver greater value to clients and members. From expanding value-based care contracts with over 650,000 providers to leveraging digital tools like HealthOS for real-time data and gap-closure, Anthem is enabling…

Read More
food as medicine
Food As Medicine
May 22, 2025

Dr. Kofi Essel, community pediatrician and Elevance Health’s Food as Medicine Director, joins Brent to discuss how nutrition is becoming a central lever in both preventing and treating chronic disease. With millions of Americans living with diabetes, hypertension, and obesity, Dr. Essel explains how Elevance is building interventions that help members access high-quality food and…

Read More
inclusive care
Inclusive Care
May 22, 2025

Sammy Gonzalez, Regional Vice President at Elevance Health, joins Brent for a deeply personal and impactful conversation on health equity and inclusive care. Sammy shares a powerful story of medical misdiagnosis tied to cultural assumptions, underscoring how bias—even unintentional—can hinder care quality. He highlights Elevance’s work to improve diversity in provider networks, enhance cultural competency,…

Read More
sydney health
Sydney Health Demo
May 22, 2025

In this episode, Christina Firouztash, Executive Advisor of Digital Solutions at Anthem, gives a dynamic walkthrough of the Sydney Health app—Anthem’s flagship digital member experience. Christina showcases how Sydney delivers personalized, simple, and equitable navigation across benefits, including virtual care, pharmacy, financial transparency, and social services access. From contextual chatbots and ID card access to…

Read More