Trump’s Transparent Hospital Pricing Pays Off for Industry — But Not So Much for Patients

“We’re going to post this, all the prices of everything,” Health and Human Services Secretary Robert F. Kennedy Jr. said at a recent event hosted by the conservative Heritage Foundation in Washington.

It’s a bold and familiar promise; Politicians from both parties have been saying this for years. Both Trump administrations — and the Biden administration in between — have taken steps to make medical pricing more accessible, with the goal of allowing patients to shop for better deals.

The idea makes intuitive sense. Why couldn’t you compare prices for MRI scans, for example?

The federal government has made some progress. Prices are available, although in confusing or fragmentary form. But there’s a big problem: “There’s no evidence that patients are using this information,” said Zack Cooper, a health economist at Yale University.

Healthcare is an inherently complex market. 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. Additionally, the same hospital usually has different contract terms with each insurer, making it even more difficult for patients to compare prices.

Instead of helping consumers sort things out, this federally mandated pricing data has become largely a tool for providers and insurers, seeking information about their competitors — so they can use it at the negotiating table in pursuit of lower rates.

“We use transparency data,” said Eric Hoag, an executive at Blue Cross Blue Shield of Minnesota, emphasizing that the insurer wants to make sure health care 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.”

Despite all the hard fighting, it is not clear that these policies had much effect overall. 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.

Price is not the only element of information 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’re falling short of their peers, saying, for example, that they need higher incomes to match their competitors’ salaries.

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