President Trump signs executive order on healthcare price transparency

President Donald Trump on Tuesday signed an executive order aimed at bolstering healthcare price transparency across radiology and other specialties. 

During his first term, the administration in 2019 finalized a rule that would require hospitals to provide upfront pricing for several imaging studies. Trump noted that implementing these provisions could cut costs for employers while saving the healthcare system billions. 

However, the White House noted progress on price transparency has “stalled” since then, and the administration wants to reignite interest. 

“The American people deserve better,” the Feb. 25 executive order states. “Making America healthy again will require empowering individuals with the best information possible to inform their life and healthcare choices. By building on the historic efforts of my first term, my administration will make more meaningful price information available to patients to support a more competitive, innovative, affordable and higher quality healthcare system.”

Trump said he is seeking “radical price transparency” through Tuesday’s order. He is directing the departments of Treasury, Labor and HHS to “rapidly” implement and enforce regulations issued under his first term. This will include ensuring hospitals and payers are disclosing “actual prices, not estimates” and updating enforcement policies to ensure both are compliant. 

“When healthcare prices are hidden, large corporate entities like hospitals and insurance companies benefit at the expense of American patients,” the White House said in a corresponding fact sheet. “Price transparency will lower healthcare prices and help patients and employers get the best deal on healthcare.”

The original 2019 rule included a list of 300 “shoppable” healthcare services for which hospitals must disclose pricing. Among them were over a dozen imaging services such as MRIs of the leg joints, X-rays of the lower back, and CT imaging of the pelvis with contrast. The Trump administration said at the time that hospitals would face fines if they failed to conform.

However, research since then has documented poor compliance with these rules in the years that followed. A 2022 JAMA study noted that only about 39% of sampled children’s hospitals complied with price transparency provisions. Another 2023 “secret shopper” analysis co-authored by billionaire entrepreneur Mark Cuban discovered that many hospitals are missing the mark on communicating imaging prices to consumers. 

“It’s wrong that the same procedure can be 20 times more expensive in one hospital than in another, and there’s no other industry where consumers are in the dark on the price of what they’re buying,” former U.S. Sen. Mike Braun, R-Ind., said last year after proposing a bill (that failed to pass) to close these loopholes. “Knowing what healthcare services cost will lower healthcare prices because Americans can shop around and get the best deal rather than relying on insurers to negotiate with providers, which drives the price up for everything.”

Hospitals opposed the transparency mandate and attempted to fight it in court, but the effort failed. Compliance rates have increased over the past four years since the rule took effect in 2021, according to startup Turquoise Health. About 90% of hospitals posted a machine-readable file with at least some of the necessary services as of 2023. The American Hospital Association puts the number at about 7 out of 10. Meanwhile, CMS has issued civil monetary penalties to 18 hospitals ranging from $44,000 to $979,000, Fierce Healthcare reported.