Healthcare Price Transparency: New Executive Order Shakes Up Hospital Compliance

A Seismic shift is underway in the healthcare industry as a new executive order, issued in February 2025, intensifies the focus on healthcare price transparency. Patients are clamoring for clarity on medical costs, and the federal government is responding with mandates designed to empower consumers and hold healthcare providers accountable.

The Order compels three key federal departments-Health And Human Services, Labor, And Treasury-to enact important changes by May 26, 2025. The Aim is simple: to provide patients with straightforward, accessible pricing information that allows them to make informed decisions about their care.

Key Mandates of The New Executive Order

The Executive Order lays out specific actions these departments must take:

• real Price disclosure: Hospitals and health plans must post actual prices, not just estimates, for medical items and services.
• Standardized Data: Pricing data must be standardized, ensuring easy comparison across different providers and insurance plans.
• Enhanced Enforcement: Compliance will be strengthened through updated guidelines and proposed regulations.

These mandates build upon existing regulations like the Hospital Price Transparency Rule and the No Surprises Act, creating a more robust framework for price transparency.

The Foundation: Hospital Price Transparency Rule and No surprises Act

The Hospital Price Transparency Rule was designed to give consumers easy access to hospital pricing information. This empowers patients to shop around and make informed choices about their healthcare.

Complementing this, The No Surprises Act protects patients from unexpected out-of-network bills for emergency and certain non-emergency services received at in-network facilities, preventing financial shocks.

Why Transparency Matters To Patients

Patients overwhelmingly desire to understand the true cost of their care. A recent study indicated that 38% of patients reported a better payment experience when they understood costs beforehand.

Despite this desire, many struggle to decipher their insurance coverage. “The State Of Patient Access 2025” reveals that 56% of patients need help from their providers to understand what their insurance covers.

Furthermore,while more patients are receiving estimates,the accuracy of these estimates has declined for the third consecutive year.Inaccurate estimates lead to uncertainty and can cause patients to postpone or cancel necessary treatments.

Cost Transparency Improves Patient Decision-Making

The Financial aspect of healthcare can be overwhelming, especially with rising costs. Patients want to know how much care will cost, assess their budget, and determine affordability.

Transparent pricing puts patients in control. When providers offer accurate,upfront patient estimates,individuals can make well-informed healthcare and financial decisions. A staggering 77% of patients want their providers to explain their insurance coverage before treatment.

Moreover, 81% of patients report that accurate estimates help them prepare to pay their medical bills, encouraging them to seek necessary care without delay.

Benefits of Hospital Price Transparency For Providers

Non-compliance with price transparency rules can result in penalties and damage a providerS reputation. The Centers For Medicare & Medicaid Services (CMS) is intensifying enforcement of price transparency regulations following the new executive order.

Notably, enforcement actions in the first two months of 2025 surpassed all of 2024. Healthcare organizations with robust price transparency tools are well-positioned to meet current and future regulations.

Besides compliance, price transparency offers financial benefits, such as increased prompt patient payments. Experian Health data indicates that 38% of patients have a better payment experience when they understand the cost of care upfront. This leads to fewer collection efforts, maximized revenue, and minimized bad debt.

The Role of Price Transparency Tools

As regulatory demands evolve, price transparency tools are essential for hospitals to maintain compliance, enhance the patient financial experience, and reduce administrative burdens.

Tools like Patient Estimates from Experian health and Cleverley + associates offer several advantages:

• More Accurate Estimates: Generate real-time estimates using current payer contracts, fee schedules, and historical claim data.
• Audit Protection: Built-in reports align estimates with actuals, track collections, and ensure continuous compliance readiness.
• Improved Workflows: Streamline estimate delivery, reduce errors, and easily scale to replace manual processes.
• Enhanced Patient Access: Self-service portals provide convenient access to personalized estimates. complementary tools like Patient Financial Advisor enable text delivery and in-office PDF downloads.

Some clients have reported a nearly 133% increase in collections through automated estimate delivery.

Moving Toward A Transparent Healthcare Future

Experian Health is dedicated to developing solutions that strengthen price transparency. Through its partnership with Cleverley + associates, the company simplifies hospital compliance and enhances patient understanding of healthcare costs.

How do you think increased price transparency will affect your healthcare decisions? What further steps should be taken to improve patient financial literacy in healthcare?

Share your thoughts in the comments below. How do you think these changes will affect your experience with healthcare costs?