As health care costs continue to rise with inflation, the need for accurate pricing of hospital and provider services is critical to health plan participants. As a result, price transparency has taken a prominent spot  in the national spotlight.

Newly enacted federal legislations are designed to protect and empower patients by mandating transparent access to hospital and provider price information and enable fully informed, cost-conscious decisions about their health care options. In turn, price transparency is triggering a (re)introduction of consumer-driven strategies that are aligned with the health care industry's shifts toward cost-effective, value-based care. Price transparency provides an opportunity for benefit professionals to better serve their clients by facilitating accurate fee insights and helping reduce participant costs. But benefit professionals first need to understand price transparency from the participant and provider perspectives, the compliance mandates new federal regulations aim to achieve, and most importantly, what strategies benefits advisors and brokers can take to optimize their role and value. 

A new dynamic between patient and provider

Price transparency puts patients in the driver's seat to control their health care decisions and dollars. This empowerment is especially important for participants in an employer-sponsored health plan. Many workers are "financially fragile" and have not set aside savings specifically earmarked for out-of-pocket medical expenses, including regular cost sharing like deductibles, copayments, and coinsurance.