• What is my current price position?
• Do I understand the payor/provider dynamics in the market?
• What is my brand and how can I leverage it?

1. Establish a sustainable governance structure (e.g., Price Transparency Council) to ensure organizational alignment
2. Understand your price and rate position relative to your market comparators
3. Evaluate your brand identity and areas of strengths in the market
4. Assess your market power as it relates to payor rates

• What are my confidentiality concerns? Do I have existing NDAs with certain payors?
• Are there areas with high transparency exposure that should be evaluated for an off-cycle price change?

1. Evaluate services with high transparency risk (e.g., shoppable) and consider off-cycle price changes
2. Communicate with payors what exactly you will be posting, especially payors with existing confidentiality agreements
3. Build the required machine-readable files in formats ready for website upload

• What is my marketing plan to ensure I am in control of the value narrative?
• How to I develop a communication strategy to effectively engage with patients and payors?

1. Design a consumer-friendly patient engagement strategy that encourages a transparent patient provider dialogue around cost of care
2. Expect rate pressure from payors, and develop a proactive communication strategy to facilitate favorable contract negotiations
3. Be ready for media inquiries with a consistent, defensible message

Health care transparency regulations are accelerating market disruption. Providers that delay action will be caught in an unfavorable position trying to regain market share from more innovative competitors.

• 60% of consumers said they would be more likely to go to a hospital that publishes its prices in comparison to the local market.¹

Traditional fee for service margins are decreasing, innovative providers who engage the younger generations of consumers will use price transparency as a catalyst to gain consumer trust and increased market share.

• Nearly 50% of Millennials and Gen-Xers reported using online reviews and ratings when choosing their physician or provider the last time they shopped for medical care.²

Changes in consumer behavior are forcing a new patient engagement paradigm. Plans and providers must evaluate how to improve patient experience through health care transparency.

• 53% of consumers said they would evaluate quality ratings, satisfaction ratings, and patient reviews across providers when making a health care decision.³

Plans and providers need to collaborate and put patients first by developing robust consumer and plan engagement strategies to increase health care pricing transparency and build trust.

• 46% of consumers with health insurance said they have gained a better understanding of their benefits since the COVID-19 crisis began, a trend that is likely to continue.⁴