A single company just made price transparency a whole lot easier

For years, the Centers for Medicare & Medicaid Services (CMS) mandate for hospital price transparency sounded like a victory for consumers. Launched in January 202, the rule required nearly every hospital in the U.S. to publicly disclose its negotiated prices with insurers in a comprehensive, machine-readable format (MRF). The goal was to unlock competition and drive down the astronomical cost of care by giving patients, payers, and researchers actionable data. 

The reality, however, was a swamp of data fragmentation. Hospitals posted files that were often incomplete, scattered across obscure domains, or encoded in proprietary systems that defied standardization. By late 2024, compliance reviews by groups like PatientRightsAdvocate.org found that while almost all hospitals had posted an MRF, only about 21 percent were fully compliant with all aspects of the federal ruling, with a separate analysis estimating that 46 percent of hospitals failed to meet the machine-readable file requirements specifically. Despite CMS increasing the maximum potential penalty for non-compliance to as much as $5,500 per day for large facilities, the enforcement efforts often lagged behind the industry’s resistance. 

Now, a single analytics firm, Trilliant Health, has bypassed the regulatory quagmire by announcing the free public release of the aggregated and standardized price data. The data directory consolidates over 5 billion negotiated rates from more than 5,000 hospitals nationwide, creating a centralized, accessible resource that finally fulfills the technical promise of the federal mandate. 

Price transparency ‘cottage industry’

The need for a private solution highlights a fundamental market failure created by the fragmented compliance environment. Because the data was posted publicly but made intentionally difficult to collect, a “cottage industry” emerged. Specialized vendors began charging high fees to aggregate, clean, and standardize the very data that the government required hospitals to make publicly available at no cost. 

“A cottage industry has emerged charging substantial fees for access to data that’s supposed to be public, a prime example of the oft-cited waste in the U.S. healthcare system,” said Hal Andrews, President and Chief Executive Officer of Trilliant Health in a statement. “The first step in reducing healthcare waste is to stop spending money on things that are free.” 

“With Oria, we made it easy for every American to get plain language answers about hospital pricing,” Andrews continued. “We have now enabled every health economy stakeholder – even our competitors – to reduce waste and by making the underlying data available at no cost and in one centralized location. With this data, every health economy stakeholder can quantify and deliver – or demand – the value for money that is so elusive in the U.S. healthcare system.” 

The opacity surrounding hospital pricing has historically given providers immense leverage in negotiations, contributing to the vast price variation seen across the country. Research has repeatedly demonstrated that prices for the same healthcare service can differ by 40 to 50 percent within a single metropolitan statistical area, with no link to quality. Without standardized, usable data, consumers and employers have had limited ability to shop for services, dampening the intended market competition.