Health Care
Healthcare Price Transparency
THE PROBLEM
The lack of transparency in healthcare pricing means that patients often don’t know the cost of care they receive until they get the bill, shielding hospitals and other providers from competition.
THE SOLUTION
Arm consumers with the information they need to make healthcare decisions.
What We Don’t Know Is Costing Us
Advocates of government-run healthcare often claim that market forces do not operate in healthcare. However, they neglect to mention that competition has been artificially suppressed by a lack of price transparency. Studies have found wide variation in prices paid for healthcare procedures across regions and among hospitals. In the most extreme cases, the same procedure can cost more than 40 times as much at the same hospital, depending on the patient’s insurance or lack thereof.
Price transparency allows patients to compare providers, encourages competition, and helps insurers and employers control healthcare costs.
Stronger Rules Still Aren’t Enough
Federal price transparency rules have continued to evolve. Since July 2024, hospitals have been allowed to report some negotiated rates as percentages or algorithms when a price cannot be stated as a fixed dollar amount. As of April 2026, hospitals using those methods are required to provide enough information for the public to calculate the negotiated rate. Yet technical compliance with these rules does not always give consumers usable prices.
PatientRightsAdvocate.org’s September 2026 report found that 49.4% of the 2,000 hospitals reviewed fully complied with the federal rule, up from 21.1% in its previous report. However, only 18% posted dollars-and-cents prices for at least half of their items and services. In Missouri, 25 of the 46 hospitals reviewed met that pricing-sufficiency standard. Separately, all eight SSM Health facilities reviewed were classified as noncompliant with the federal rule. In 2026, Missouri enacted a hospital price transparency law that restricts medical debt collection for noncompliant hospitals.
However, these protections depend on federal enforcement rather than state action. Furthermore, providers are only half of the healthcare equation; not only should all providers be subject to the same price transparency requirements, but payers for services such as healthcare plans should be required to publicly post the rates they negotiate. Until patients can be informed consumers of the care they purchase, we can’t expect to keep the cost of medical services under control.
POLICY RECOMMENDATIONS
- By state law, require that hospitals and other healthcare providers publish pricing information to the public in user-friendly and machine-readable formats.
- Prohibit providers from pursuing medical debt collection if they are found to be noncompliant with state transparency requirements.
