---
title: Price Transparency Is Getting Better Data. Now, What Will We Do with It?
description: Explore the latest news out of the Oct. 5th price transparency event in Washington DC. and high-level thoughts on the CMS-9882-F final rule.
image: https://blog.pocp.com/hubfs/price%20transparency%20in%20healthcare.png
---
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# Insights: Brief Points of View
# POCP Blog
---
## Price Transparency Is Getting Better Data. Now, What Will We Do with It?
- October 07, 2026
- By [Vanessa Candelora](https://blog.pocp.com/blog/author/vanessa-candelora)
- [0 Comment](https://blog.pocp.com/blog/price-transparency-is-getting-better-data.-now-what-will-we-do-with-it#comments-listing)
Share this story:
Before the healthcare price transparency event in Washington, D.C., this past Monday, October 5, little was known about the full agenda or what would be covered. I went in blind but left glad I could attend in person.
The Departments of Health and Human Services, Labor, and the Treasury released the [**Transparency in Coverage Final Rules (CMS-9882-F)**](https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rules-cms-9882-f). This final rule improves upon the requirements established under the existing Transparency in Coverage (TiC) rules. The government also announced the next steps toward developing a standardized schema for prescription drug machine-readable files (MRFs).
The event highlighted CMS's vision for what better price transparency data can enable. Two panels examined how employers and technology companies are using it to make healthcare more shoppable and give employers and patients better information for healthcare decisions.
I kept thinking beyond the requirements: What happens as this data becomes more accessible, usable, and complete? How might that change the roles of health plans, employers, technology companies and providers?
## Making Price Transparency Data More Usable
CMS-9882-F addresses several barriers to using the existing MRFs.
The requirements will make files smaller and easier to find, download, and use. Files will be optimized by no longer including provider-rate combinations unlikely to reflect services a provider would furnish. The rule will require context for interpreting the remaining data and attestations of accuracy and completeness.
Cleaner, more accessible, and better contextualized data intends to give employers, consumers, researchers, health plans, and technology companies a stronger foundation for action.
The rule also reinforces access to personalized member cost-sharing information: In addition to internet-based and paper options, plans and issuers must provide it by phone upon request, aligning with No Surprises Act TiC requirements for specific, informative patient-centered cost estimates.
## What Does Greater Transparency Mean for Health Plans?
One of my biggest takeaways from the employer discussion was what usable pricing data could mean for large employers, especially self-funded ones.
As employers, third-party administrators (TPAs), and plan fiduciaries gain better data on negotiated rates and provider networks, they can more closely evaluate benefits, negotiate provisions, and make network decisions for their employee populations.
For health plans, that raises strategic questions: How will employer group, administrative services only (ASO), and self-funded products evolve? What will employer customers expect from plan design, network products, analytics, and decision support? Where can plans continue to differentiate?
These questions matter now. Price transparency is no longer only about compliant files; more usable data will shape the products, services, and insights employers expect from health plan partners.
## Prescription Drug Data Could Fill an Important Gap
I was particularly interested in plans to develop a standardized schema for the Prescription Drug File, a major missing piece in price transparency.
Technology companies have made progress using medical pricing data, including information on drugs administered under the medical benefit, such as infusion therapies. Prescription drugs covered under the pharmacy benefit remain a significant gap in publicly available MRF data.
A standardized prescription drug file could help technology companies give consumers a more complete view of healthcare costs.
But the information must reach the right moment. Ideally, a prescriber and patient should be able to use cost information during the visit as they weigh treatment options. I’m thinking about the Real-Time Pharmacy Benefit Check data standards that address the point-of-prescribing problem but, but have struggled to gain widespread adoption.
Will new tools sit outside the provider workflow, or will greater transparency put cost information inside the clinical workflow where treatment decisions occur?
That distinction matters. Useful cost information should support decisions at the point of care, not create another disconnected step for patients or providers.
## Who Owns the Consumer Experience?
The event’s panels featured employers and technology companies, but no health plan or provider speakers. That omission stood out because plans and providers remain central to what happens after consumers encounter pricing information.
An early concern in this work was that third parties could lead the consumer cost experience while health plans and providers still had to explain discrepancies between displayed information and actual costs. Better data can reduce that risk, but it also makes cross-industry collaboration more important.
The opportunity is to use better data and technology to reduce healthcare complexity for the average consumer, not simply explain it.
## Price Is Only Part of the Equation
Participants agreed that consumers should not choose care on price alone and that quality should be a primary consideration. Unfortunately, participants disagreed on which quality measures should matter most.
Some emphasized clinical measures focused on things like complications, readmissions, and health outcomes. Others focused on the long-term costs of lower-quality care or on the consumer experience, including providers’ experience, education, and bedside manner.
To support informed decisions, we need to define quality for the decision at hand and present it in a form consumers can understand.
We know that the highest cost does not equal the highest quality. We also know a lower unit price may not mean lower total cost if it leads to poorer outcomes or additional services. Conversely, a clinical measure may not address everything a patient values when choosing a provider.
Making healthcare more shoppable requires both price and meaningful quality information.
## From Making Data Available to Making It Useful
My biggest takeaway is that as price transparency data improves, the competitive advantage may belong not to those who publish data, but to those who help people act on it.
Health plans should assess what greater price transparency means for their products, employer relationships, and member experience. Employers can evaluate benefits and networks more closely. Technology companies can build better patient-centered decision-support tools. Providers must help determine how cost information reaches patients when they make healthcare decisions.
Point-of-Care Partners helps organizations turn price transparency requirements into strategy. We educate teams on the regulatory and market landscape, develop approaches for members, employer groups, products, and partner relationships, and assess existing tools and capabilities to identify gaps and guide product roadmaps.
If these changes are prompting you to reassess your approach, [let’s talk](https://www.pocp.com/contact/)about where you are today and the roadmap needed to make the data useful for your members, clients, and business.
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