Health Systems Grapple with Trump’s Price Disclosure

In a sharp return to first-term priorities, President Donald Trump has signed a new executive order to revive and expand healthcare price transparency regulations first introduced under Executive Order 13877. Framed as a cornerstone of the “Make America Healthy Again” agenda, the April 2025 directive directs federal agencies to rapidly enforce and strengthen rules requiring hospitals and health plans to publicly post pricing information—not estimates, but actual prices.

While the administration touts potential savings for consumers, the healthcare industry is now racing to assess the operational and financial impact of what Trump calls “radical transparency.” For health systems, insurers, and digital health vendors alike, the implications go far beyond compliance—they may fundamentally alter how healthcare is priced, marketed, and purchased.

The Executive Order: A Renewed Push

Trump’s new directive—signed in early April—requires the Department of Health and Human Services (HHS), Department of Labor, and Department of the Treasury to take “all necessary and appropriate action” within 90 days to update, enforce, and expand price transparency regulations. Specifically, the order mandates:

Hospitals must disclose actual, not estimated, prices for services and procedures.
Health plans must publish their negotiated rates with providers and actual drug prices paid.
Consumer-facing internet tools must provide individualized out-of-pocket cost estimates for members.

The administration cited a Congressional Budget Office analysis suggesting up to $80 billion in consumer savings if fully implemented, alongside private reports projecting 27% cost reductions across 500 common services.

Compliance Fatigue and Fragmented Readiness

Despite being law since 2021, compliance with federal transparency rules remains uneven. According to a January 2025 analysis from Turquoise Health, only 43% of hospitals are fully compliant with machine-readable file requirements, while fewer than 25% have consumer-facing tools that meet usability standards.

“We’ve seen progress, but many systems simply haven’t prioritized it,” said Chris Severn, CEO of Turquoise Health, in a Modern Healthcare interview. “This new executive order is going to push CFOs and compliance teams into high gear.”

For hospitals still struggling with post-COVID financial instability and workforce shortages, the renewed enforcement effort is unwelcome timing. Several large health systems, including CommonSpirit Health and Advocate Health, have issued internal memos indicating that transparency platform upgrades will be fast-tracked in Q2 2025.

Price Transparency Meets Public Scrutiny

Increased visibility into negotiated prices is already fueling public discourse—and in some cases, public outrage. A recent RAND Corporation report found that prices for common outpatient services vary by as much as 400% between hospitals in the same metro area, even among facilities owned by the same parent system.

This inconsistency has emboldened employer groups such as the Purchaser Business Group on Health (PBGH), which is now lobbying Congress for stricter enforcement and site-neutral payment reforms. “If you’re charging $3,000 for a colonoscopy that costs $800 across town, you better have a compelling reason,” said PBGH CEO Elizabeth Mitchell during a March 2025 testimony to the Senate HELP Committee.

Self-insured employers and health plan administrators are also using transparency data to renegotiate contracts and design steerage strategies, creating new demand for advanced analytics and contracting software platforms.

Digital Infrastructure Strained

With more granular pricing data required than ever before, digital health infrastructure is showing signs of strain. Vendors such as HospitalPricing.com and Clarity Software report spikes in demand for tools that parse and normalize pricing files across hospitals and plans.

“This is not just a reporting requirement,” said Nisha Jain, VP of product strategy at Clarity Software. “It’s a structural transformation. The hospitals that win in the transparency era will be those that can present complex data in consumer-friendly formats and use it to drive digital engagement.”

The operational lift is especially heavy for rural or safety-net hospitals, where IT staff and vendor budgets are limited. Some industry groups are now calling for new CMS grants to support implementation in low-resource settings.

The Clinical Risk: Misinterpreted Data and Patient Confusion

As more patients turn to online tools to compare prices, there is a growing concern that lack of context could lead to poor medical decisions. Providers worry that patients may interpret lower prices as lower quality—or may delay essential care in pursuit of the cheapest option.

“Transparency must come with education,” said Dr. Ana Chen, medical director at HealthSparq, a healthcare navigation platform. “Otherwise, we risk undermining trust in providers and confusing people about what really matters—outcomes and appropriateness.”

What’s Next: Enforcement, Litigation, and Tech Opportunity

The Departments of Labor, HHS, and Treasury are expected to release new enforcement guidance by July 2025. Industry insiders expect that noncompliant organizations could face increased financial penalties or public flagging on CMS transparency dashboards.

Simultaneously, consumer advocacy groups are preparing legal challenges to force more consistent compliance. In March, the nonprofit Patient Rights Advocate filed a petition to HHS urging the agency to publish quarterly compliance scores for all hospitals.

For forward-thinking digital health firms, the new order represents a market opportunity. Platforms that can combine pricing data, outcomes metrics, and personalization will be well positioned to power a new generation of healthcare decision tools for employers, payers, and consumers.

But for the rest of the industry, the transparency train has left the station—and there’s little time left to catch up.

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Radical Transparency or Revenue Disruption? Health Systems Grapple with Trump’s Price Disclosure Mandate