“National pricing data show the cost of healthcare services varies greatly by payer, geography, setting and facility, presenting new fiduciary considerations for employers.”

“Because this pricing information wasn’t historically available, employers weren’t necessarily responsible for picking the highest value health plan for their employees,” she said. “This also shift the onus and responsibility to employers to use the leverage they have in the market to start changing some of this pricing as well.”

“Analyzing six inpatient procedures nationwide, negotiated rates differed by an average ration of 9.1 across the country, the Trilliant report found. This means, for example, negotiated rates for one type of coronary bypass could range from $27,000 to nearly $250,000.

“Researchers said they didn’t find a correlation between provider quality and price, despite some hospitals being named on prominent “best hospitals” lists. In many instances, there seemed to be no rhyme or reason to prices.”

“One trend researchers did spot: The median rate for ambulatory surgery centers was always lower than in hospital outpatient departments across five surgeries. This includes colonoscopies, which can be 67% less expensive. They estimate that yearly savings exceed $4.5 billion on the procedure alone.”

“Historically, federal law prevented pricing information from being public, under the assumption it would lead to higher prices and collusion. Private contracts also included gag clauses, requiring the information to be kept confidential.

Oakes said new price transparency regulations will force healthcare to act more like other markets,since the report will allow people to “name name” and highlight the worst practice offenders.”

“Armed with pricing data, employers may confront new legal obligations when selecting health plans”
Noah Tong Fierce Health Care, 8/18/2025