Trump Required Hospitals To Post Their Prices for Patients. Mostly It’s the Industry Using the Data.

Republicans believe patients should seek better prices for health care. The party has long insisted on giving money to patients and letting consumers do the work of cutting costs. After some Republican lawmakers closed out 2025 by advocating for funding for health savings accounts, President Donald Trump introduced his Big Health Plan, which calls for, among other policies, requiring providers and insurers to post their prices “at their place of business.”

The idea echoes a policy implemented during his first term, when Trump suggested that requiring hospitals to post their prices online could alleviate one of the most common complaints about the health care system: the lack of up-front pricing. For anyone who received a bill three months after treatment and discovered mysterious charges, the idea seemed intuitive.

“You can go online and compare all the hospitals and all the doctors and the prices,” Trump said in 2019 at an event unveiling the price transparency policy.

But amid low compliance and other challenges implementing the policy since it took effect in 2021, available pricing data is scarce and often confusing. And instead of patients seeking medical services, it’s primarily health systems and insurers who use what little data is available, turning it into negotiations that determine which medical professionals and facilities get paid for which services.

“We use transparency data,” said Eric Hoag, an executive at Blue Cross Blue Shield of Minnesota, emphasizing that the insurer wants to make sure providers don’t receive significantly different rates. It’s about “making sure that we’re competitive, or, you know, more than competitive with other health plans.”

Not all hospitals have complied with price transparency rules, and many have been slow to do so. A study conducted during the first 10 months of the policy found that only about a third of establishments had complied with the regulations. The federal Centers for Medicare & Medicaid Services notified 27 hospitals between June 2022 and May 2025 that they would be fined for noncompliance with the rules.

Difficulties in making health care prices accessible have spurred greater federal action since Trump’s early efforts. President Joe Biden has made his own decision on this dilemma, demanding increased data standardization and toughening compliance criteria. And in early 2025, struggling to deliver on his promises to lower health care costs, Trump tried again, signing a new executive order urging his administration to fine hospitals and doctors who failed to list their prices. CMS followed through on regulations intended to increase fines and increase the level of detail required in pricing data.

So far, “there’s no evidence that patients are using this information,” said Zack Cooper, a health economist at Yale University.

In 2021, Cooper co-authored a paper based on data from a large commercial insurer. Researchers found that on average, patients who need an MRI pass through six less expensive imaging providers to get from home to a scan appointment. That’s because they follow their doctor’s advice about where to receive care, the study found.

Executives and researchers interviewed by KFF Health News also didn’t think opening up the data would significantly change prices. Research shows that transparency policies can have mixed effects on prices, with a 2024 study of a New York initiative finding a marginal increase in fees charged.

The policy outcomes so far appear to put a damper on long-held hopes, particularly from the Republican Party, that greater price transparency would incentivize patients to find the best deal for their imaging or knee replacement.

These aspirations have not been met for several reasons, researchers and industry insiders say. Some patients simply do not compare services. But unlike apples – a Honeycrisp and a Red Delicious are easy to line up side by side – medical services are difficult to compare.

On the one hand, it’s not as simple as a single price for a medical stay. For example, two babies might be delivered by the same obstetrician, but the mothers might be charged very different amounts. A patient may be given medication to speed up contractions; another might not. Or, one might need an emergency C-section – one of many cases in medicine in which getting this service simply isn’t an option.

And data is often presented in ways that aren’t useful to patients, sometimes buried in spreadsheets and requiring in-depth knowledge of billing codes. In calculating these costs, hospitals make “detailed assumptions about how to apply complex contract terms and evaluate historical data to create reasonable value for an expected authorized amount,” the American Hospital Association told the Trump administration in July 2025 as part of efforts to increase transparency.

Costs vary because hospitals’ contracts with insurers vary, said Jamie Cleverley, president of Cleverley and Associates, which works with health care providers to help them understand the financial impacts of changing contract terms. The cost for one patient with one health plan may be very different from the cost for the next patient with another plan.

The fact that hospital prices can be confusing to patients is a consequence of the lack of standardization of contracts and their presentation, Cleverley said. “They are not harmful.”

“Until we align as an industry, there will be this variation in terms of how people perceive data and its usefulness,” he said.

Instead of helping buyers, federally mandated data has become the basis for negotiations — or sometimes lawsuits — over the appropriate level of compensation.

The main use of price data for health care providers and payers, such as insurers, is “to use it in their contract negotiations,” said Marcus Dorstel, an executive at price transparency startup Turquoise Health.

Turquoise Health gathers pricing data by grouping service codes using machine learning, a type of artificial intelligence. This is just one example in a cottage industry of startups offering pricing insight. And, online, ads from startups selling their products often focus on hospitals and their periodic tussles with insurers. Turquoise has payers and providers as clients, Dorstel said.

“I think nine times out of ten you’ll hear them say that price transparency data is now a critical part of contract negotiation,” he said.

Of course, prices are not the only variable on which negotiations are based. Hoag said Blue Cross Blue Shield of Minnesota also considers quality of care, rates of unnecessary treatment and other factors. And sometimes negotiators feel like they need to keep up with their peers, saying, for example, that they need higher incomes to match their competitors’ salaries.

Hoag said doctors and other providers often look at data from comparable health systems and say, “I need to be paid more.” »