Seeking more transparency in hospital prices in 2026

Hospitals and health systems have received criticism for the difficulty the average consumer faces in trying to understand how much procedures will cost, but there may be more visibility in pricing in the coming year.

Carol Skenes, chief of staff at Turquoise Health, tells Chief Healthcare Executive® that she’s optimistic about progress on hospital price transparency.

She sees growing interest from the federal government and policymakers, and increasing pressure from employers as they deal with rising prices for health care.

“We've heard a lot more about price transparency this year,” Skenes says.

President Trump issued an executive order in February calling for hospitals and health insurance companies to make it easier for consumers to see and compare prices. Trump imposed new regulations on price transparency in his first term.

Hospitals are facing deadlines on new price transparency requirements from the Centers for Medicare & Medicaid Services. Health systems must update their machine-readable files outlining prices for procedures by April 1. (The deadline is technically Jan. 1 but enforcement isn’t slated to begin until April, CMS says.)

Skenes says she’s seeing a commitment to hospitals and payers both having prices listed in machine readable files that are easier for consumers to access.

But she’s seeing more lawmakers talking about measures that would require more clarity in prices.

As Skenes says, “We need the data in the allowed amount forms or in some true dollar value so that it can be available for patients, for them to understand: what does this mean if I have Aetna? What does this mean if I have a 10% copay? What does this mean if I have a deductible?”

Even with progress in getting rates in machine readable files, Skenes says it’s still not easy for even those familiar with the healthcare industry to get a handle on how much they’d pay for a certain procedure, and it’s far more perplexing for the average consumer. But Skenes says policymakers are showing interest in making more headway for consumers.

“We're seeing in the way policy is written now, a point to the convergence, which is to say, all of this needs to be a means to an end, to lower the barrier to entry for patients to understand what their cost of care is,” Skenes says. “We're not there yet, but now the conversation is happening with a lot more frequency, and so I'm optimistic that that conversation will continue well into 2026.”

U.S. Sens. Roger Marshall, R-Kansas, and John Hickenlooper, D-Colo., have introduced a bill that would require hospitals and health systems to offer more information on prices. The bill, the Patients Deserve Price Tags Act, would require hospitals and other providers to provide the actual prices, costs and negotiated rates for services. The measure would apply to hospitals, ambulatory surgery centers, imaging centers and laboratories.

Skenes says the bipartisan interest in price transparency is encouraging.

“You want to know what the cost of your care is going to be,” she says. “And so from that perspective, we can all be held accountable, separate from the politics of it, to say the system of understanding how health care should be paid is confusing and opaque for all of us. And so for every stakeholder that could and should be accountable to incrementally improving that, they all should. And I think that’s what we’re hearing.”

Plus, the Trump administration’s focus on greater price transparency could add more momentum, she says.

“What we're seeing from this administration is broad support,” Skenes says.

The CMS also introduced a new proposed Transparency in Coverage rule that would revise transparency rules for health insurers. The agency says the changes would offer more clarity on out-of-network prices and when there are changes with in-network rates and services. The proposal would also streamline some reporting requirements for insurers.

Hospitals have said that they are complying with federal regulations to post data in machine-readable files. Hospitals and healthcare organizations are required to publish 300 shoppable services and procedures in a display that can be easily read by consumers or with a price estimator tool. Turquoise Health said that most hospitals are complying with federal rules, but it’s still not easy for consumers to easily compare services.

Critics say hospitals haven’t been doing enough. Elizabeth Mitchell, president and CEO of the Purchaser Business Group on Health, which represents large businesses, told Chief Healthcare Executive® in April that she’s been frustrated with the lack of progress.

“They've had plenty of time to do it, and we understand that it's burdensome and expensive,” Mitchell said. “But you know, our current healthcare system is burdensome and expensive to its users.”

PatientRightsAdvocate.org said in a November 2024 report that only 21% of hospitals were in full compliance with federal price transparency rules, down from 34% in February 2024.

The American Hospital Association has disputed the findings of the group. The hospital association points to a CMS report in 2022 that found 70% of hospitals were complying with federal regulations.

Still, employers are looking for better information on costs, and Skenes said that could help press lawmakers into approving legislation aimed at giving companies and consumers more data.

“It's not just how much they're paying, but they need to know that the quality of the care that their own people are getting is giving them a good return on their investment,” Skenes says.