The new data arrives in the form of massive, machine-readable digital files, typically in formats inaccessible to consumers, and is mostly posted on insurers' websites. According to Turquoise Health Co., a company compiling the data, the Centers for Medicare and Medicaid Services set a July 1 deadline for the data to be released, with some big insurers releasing data by the early morning hours Friday, including Elevance Health Inc.'s Anthem, Cigna Corp., and Humana Inc.
According to a review of their disclosure website, UnitedHealthcare of UnitedHealth Group Inc. had posted files online by mid-morning Friday. CVS Health Corp.'s Aetna said ahead of the deadline that it planned to meet disclosure requirements on time.
Employers, like insurers, are required to post prices under the rule, though many are expected to delegate the responsibility to insurers and health-plan administrators.
According to Maximilian Pany, a graduate student and researcher affiliated with Harvard Medical School's Healthcare Markets and Regulation Lab, an early review of newly posted information revealed that some disclosures were incomplete, with files lacking some granular pricing data.
The data follows a batch of pricing information that hospitals began posting at the start of 2021 under a Trump administration rule. However, hospital compliance has been patchy, and their disclosure is limited to the services they provide. So far, only two hospitals have been penalized for failing to meet the rule's requirements, with fines totaling approximately $1.1 million between the two hospitals, which shared a common owner. According to a CMS spokesperson, the agency is "encouraged" by the increase in hospital compliance since last year.
The insurer data, which is required under a separate federal rule issued in November 2020, is expected to cover a much broader range of the healthcare ecosystem, including prices for free-standing surgery centers, clinics, private doctor practices, labs, and other medical-service providers.
According to Adam Geitgey, chief technology officer at Turquoise Health and one of the company's founders, the expanded data will eventually allow consumers to make more comprehensive decisions.
According to industry experts, the large and complex files are likely too difficult for many patients to use, but newly public prices will become more useful in the marketplace as companies begin to add data to consumer tools.
The prices negotiated by the insurer with its network of healthcare providers will be included in the files. The data will also include out-of-network rates, as well as the amounts billed by the provider and paid by the health plan.
"Except for pharmaceuticals, everything an insurance company pays for will be in these files," said Stephen Parente, a University of Minnesota professor who helped write the insurer rule while working for the White House Council of Economic Advisers during the Trump administration.
CMS has delayed enforcing a provision of the rule that would have required the disclosure of a database of prescription drug prices. According to a CMS spokeswoman, regulators are considering whether that portion of the rule is still appropriate in light of subsequent legislation and "stakeholder concerns."
The new requirement applies only to commercial plans for employers and individuals, not government-backed products like Medicare Advantage. The insurer rule included more specific instructions than the hospital rule, which experts believe will result in cleaner data, and it also required monthly updates. "It's more structured and precise," said Turquoise Health CEO Chris Severn.
According to Elizabeth Mitchell, CEO of the Purchaser Business Group on Health, the broader data will be useful to employers looking to decide which doctors, clinics, and other providers to include in their health-plan networks, as well as which insurers to use in the future.
"When the information is finally available, there will be a lot to learn," she said. She did, however, express disappointment with the lack of data on prescription drug pricing.