The spirit of the rules is universally agreed upon by health care stakeholders as good; if implemented in a meaningful way (including the portions due by January 1, 2023, and January 1, 2024), these rules will help consumers not only make better health care decisions, but achieve improved health outcomes, as well. In addition, they could result in cost savings for both the consumer and the employer. In other words, these new regulations have the potential to reduce the medical cost trend for 2022 and beyond—but only if consumers understand and utilize the data and tools.

Here's what employers should know and understand about the rapidly approaching milestones.

Time is running out: Meeting the compliance timelines

By January 1, 2022, plan sponsors and health plans will need to provide public machine-readable files that display in-network rates, out-of-network allowed amounts, and prescription drug pricing. By January 1, 2023, they must provide an internet-based self-service tool listing personalized, out-of-pocket cost estimates and other price-related data for 500 predetermined items and services. By January 1, 2024, they must expand this self-service tool to include all covered items, services, and prescription drugs.

Ensuring compliance with the rules lies on the shoulders of the plan sponsors and health plans. If they haven't yet, responsible parties should start making a plan for how to execute these requirements and establish a clear communication plan with the medical and pharmacy plan issuers to ensure timely access to the required data. Some employers are even modifying their contracts with medical and pharmacy issuers to delineate responsibility. It's important to note that even if a self-insured employer does decide to contract with a medical or pharmacy plan issuer to carry out these transparency provisions, the employer or plan is still accountable for non-compliance—not the third parties.

In addition, fully insured employers should have a conversation with their insurance issuer to confirm who will be taking on responsibility for data disclosure.

Price isn't the only factor: What's missing from the regulations

These new rules are a step in the right direction, but achieving better health outcomes and cost savings will require more than just price transparency. Cost is just one of many attributes that goes into choosing the right care. Consumers should be provided with additional metrics, such as network, quality, convenience, patient ratings, and provider efficiency.

Ideally, this information would be presented in a curated approach so consumers don't need to sift through and interpret all of the data on their own; in addition, provider and other care recommendations should be personalized and consumers should be presented with just a few top matches to choose from. Showing consumers every single option available can be information overload, overwhelming them and making it difficult to discern which recommendation is the best match for their unique clinical profile and health needs.

Lastly, though the rules focus on digital self-serve tools, this approach won't work for all consumers. Presenting complex concepts like bundled care and cumulative treatment limitations will raise questions. Providing human support—clinical and benefits experts who can help individuals navigate not just cost of care transparency, but their entire personal health journey—will be imperative to reach the total population, especially those with low health literacy, poor technology, and other special needs.

The employer's role: Why health benefits are at the core of workforce strategy

Employers play a critical role in encouraging and enabling their employees to regularly engage in their care. These days, more Americans trust their employer for information than the federal government or the media. Providing employees with a single, unified platform in which they can easily search for, learn about, and access providers, benefits programs and resources, and human support is key to connecting with the right care, avoiding unnecessary care (which costs the health care system billions of dollars each year), and reducing overall health care spend.

Digital health companies, benefits consultants, and employers must work together to keep consumers regularly engaged with their health—and not just when an emergency occurs or once a year during open enrollment—and help them better understand what care they need and what the most cost-effective and high-quality options are for that care.

Ultimately, the new transparency regulations are a great opportunity for employers to re-engage their population, educate them on the importance of evaluating their care options, and vastly improve their employees' overall health navigation experience; however, in order for that to happen, employers must go beyond compliance. When you give consumers the right data in the right way and at the right time, you empower them to make the best possible decisions about their unique health needs.

Jake Fochetta is the director of corporate strategy at Castlight Health. An experienced health care IT professional, he has spent more than 10 years in enterprise technology strategic planning for hospitals and health systems, operational transformation, patient engagement, and virtual care strategy development.

Read more: 

• Work in progress: Price transparency efforts need to go further
• Navigating today's benefits compliance landscape
• Hospital price transparency compliance: How's it going?