
The Presidential Price Transparency Executive Order Is Irrelevant and Speciously Justified
Description
This IDC Perspective presents that after CMS mandates for payers and providers emerged in response to "surprise billing" and obfuscation of medical pricing, now there is an "executive order." This order is speciously rationalized and ignores the fact that this concept is an expensive proposition of limited value, with legitimate pushback and sensible historical noncompliance by hospitals and payers. "Price transparency at a cursory level has been around for years, barely used by the average consumer. It was restarted as a political talking point in 2020 with mandates and now with an executive order in 2025. Significant technological enhancements are necessary if it is to be realized in payers, and some consumer expectations are totally unrealistic in commercial healthcare," states Jeff Rivkin, research director, IDC Health Insights. "One should doubt whether 'all' procedures can achieve exact predictive transparency and whether there is a large consumer desire or medical literacy to actually shop for procedures. Payers should determine comprehensively if they want to do the mandated compliance minimum or try to factor price transparency into enhancing the member's healthcare experience ostensibly toward differentiating service excellence."
Table of Contents
10 Pages
Executive Snapshot
Situation Overview
Data Quality
Noun Recognition — What's a Big Mac?
Noun Recognition — What's a Pickle?
Place Recognition: Location, Location, Location
Overpromises Versus Reality
Data Quality — Summary
Motivations
Consumer Considerations — Interest
Market Considerations — For-Profit Hospitals Versus Universal Care
Patient Considerations — External Variables Other than Price
Regulatory Considerations — Specious References Within the Executive Order
Enforcement
Advice for the Technology Buyer
Consider "Minimal Viable Product" Mentality
Consider Still That the Mandate Is Political and Might Flex Yet Again
Consider Price Transparency Solutions in the Context of the Middle and Back Office
Recognize That This Is a Tool Purchase Decision with Significant Data Integration
Learn More
Related Research
Synopsis
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Pricing
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