Insights

Healthcare price transparency insights, analysis, & updates from the Payerset team.

A Practical Look at Reimbursement Benchmarking with Price Transparency Data
Industry Insights 7 min read

A Practical Look at Reimbursement Benchmarking with Price Transparency Data

Part two of our series on benchmarking with price transparency data. A real-world example of how single-code comparisons can mislead, and what a comprehensive approach actually looks like.

March 16, 2026 Jacob Little
How to Analyze Price Transparency Data for Reimbursement Benchmarking
Industry Insights 8 min read

How to Analyze Price Transparency Data for Reimbursement Benchmarking

A framework for using price transparency data to benchmark reimbursement between hospitals, built from hundreds of customer interactions with managed care professionals.

March 10, 2026 Matt Phillips
Transparency in Coverage (TiC) Schema 2.0 Is Live - Updates
Industry Insights 3 min read

Transparency in Coverage (TiC) Schema 2.0 Is Live - Updates

February 2nd, 2026 marked the first enforcement deadline for TiC Schema 2.0. Here's what we're seeing on the ground with payer compliance and the new data fields.

February 5, 2026 Matt Phillips
CMS Proposes Major Updates to Transparency in Coverage (TiC) Rules
Industry Insights 10 min read

CMS Proposes Major Updates to Transparency in Coverage (TiC) Rules

CMS is proposing significant updates to TiC requirements including network-based file structures, annual utilization files, quarterly reporting, and enhanced out-of-network data.

February 3, 2026 Matt Phillips
Key Updates in Price Transparency: Transparency in Coverage (TiC) Schema 2.0
Industry Insights 5 min read

Key Updates in Price Transparency: Transparency in Coverage (TiC) Schema 2.0

A comprehensive breakdown of CMS's Transparency in Coverage Schema 2.0, including key improvements to provider group data, plan identification fields, service setting enhancements, and what fell short.

October 3, 2025 Jacob Little
Managed Care Contract Negotiations & Price Transparency in 2025: Lessons from the Front Line
Industry Insights 6 min read

Managed Care Contract Negotiations & Price Transparency in 2025: Lessons from the Front Line

Key insights from hospital managed care leaders on tightening margins, evolving denial behavior, shifting employer dynamics, and how organizations are building proactive defenses.

September 28, 2025 Joseph Tollison
A CFO Blueprint: What to Look for in Healthcare Price Transparency Solutions
Industry Insights 5 min read

A CFO Blueprint: What to Look for in Healthcare Price Transparency Solutions

A guide for hospital CFOs and managed care leaders on evaluating healthcare price transparency solutions, covering data accuracy, usability, flexibility, and partnership qualities.

September 27, 2025 Joseph Tollison
Why Complete Healthcare Price Transparency is Essential - And What It Takes to Get It Right
Parsing Payer MRFs 4 min read

Why Complete Healthcare Price Transparency is Essential - And What It Takes to Get It Right

Comprehensive healthcare price transparency data has become essential for fair negotiations, strategic planning, and financial forecasts. Here's why completeness matters and how to get it right.

May 14, 2025 Jerry DiMaso
The Positive Future of Price Transparency in the U.S. in 2025
Industry Insights 5 min read

The Positive Future of Price Transparency in the U.S. in 2025

Analyzing the 2025 executive order on healthcare price transparency, the challenges that must still be addressed, and the path forward for making transparency real and accessible.

February 26, 2025 Jacob Little
Industry Insights 4 min read

Making Sense of Hospital Price Transparency Data: 2025 Updates & Solutions

A breakdown of the current state of hospital machine-readable files (MRFs), the latest 2024-2025 regulatory updates, ongoing challenges, and how Payerset simplifies hospital price transparency data analysis.

February 23, 2025 Joseph Tollison
How Payerset Simplifies Healthcare Plan Complexity in Reporting
Industry Insights 3 min read

How Payerset Simplifies Healthcare Plan Complexity in Reporting

Learn how Payerset eliminates the burden of pre-selecting reporting plans, providing users with a more intuitive, comprehensive, and insightful healthcare price transparency experience.

February 21, 2025 Jacob Little
News 2 min read

Payerset and PurpleLab Partner to Deliver Trusted Price & Coverage Intelligence, Transforming Healthcare Decision-Making

Payerset and PurpleLab announce a strategic partnership to launch a trusted price intelligence solution suite, setting a new standard in healthcare intelligence.

February 13, 2025 Joseph Tollison
Unlocking the Power of Historical Price Transparency Data
Industry Insights 2 min read

Unlocking the Power of Historical Price Transparency Data

Introducing Payerset's Date Snapshot feature for historical rate analysis, enabling users to track pricing trends, benchmark against industry standards, and strengthen contract negotiations.

January 23, 2025 Jerry DiMaso
Reflecting on 2024 and What's Next for Payerset
Industry Insights 3 min read

Reflecting on 2024 and What's Next for Payerset

A look back at Payerset's accomplishments in 2024 and a preview of what's ahead for 2025, including platform redesigns, historical rate tracking, and the evolution toward complete pricing intelligence.

January 14, 2025 Jerry DiMaso
Payercast 3 min read

Exploring Price Transparency, Accountability, and Innovation in Healthcare with Andrew Gordon

A recap of our Payercast episode with Andrew Gordon, a health economics researcher, discussing healthcare price transparency barriers, accountability, and the future of healthcare pricing.

December 5, 2024 Joseph Tollison
Industry Insights 3 min read

Reflections from the Georgia HIMSS Conference: Driving Digital Transformation in Healthcare

Key takeaways from the Georgia HIMSS conference covering digital transformation, change management, crisis response lessons from Hurricane Helene, and the balance between regulatory compliance and innovation.

October 3, 2024 Joseph Tollison
Payercast S01 E03 - Price Transparency Use Cases, HFMA 2024, Late Adopters or Sitting Ducks?
Payercast 3 min read

Payercast S01 E03 - Price Transparency Use Cases, HFMA 2024, Late Adopters or Sitting Ducks?

Exploring key price transparency use cases including rate benchmarking, market expansion, and underpayment analysis, plus a case study of UofL Health's success at HFMA 2024.

August 26, 2024 Jacob Little
Contract Negotiation Powered by Price Transparency Data: A Success Story from UofL Health
Industry Insights 3 min read

Contract Negotiation Powered by Price Transparency Data: A Success Story from UofL Health

How UofL Health leveraged payer price transparency data to achieve a 33% increase in reimbursement for spine fusion procedures and transform their contract negotiation strategy.

June 29, 2024 Jacob Little
Payercast S01 E02 - Recapping The 2024 National Healthcare Price Transparency Conference
Payercast 3 min read

Payercast S01 E02 - Recapping The 2024 National Healthcare Price Transparency Conference

The Payerset team recaps the 2024 National Healthcare Price Transparency Conference, covering key discussions on data transparency, employer accountability, and healthcare cost management.

May 24, 2024 Joseph Tollison
National Healthcare Price Transparency Conference Recap
Industry Insights 3 min read

National Healthcare Price Transparency Conference Recap

Key insights from the National Healthcare Price Transparency Conference featuring Cynthia Fisher, Mark Cuban, and the RAND 5.0 study on healthcare pricing and employer strategies.

May 15, 2024 Joseph Tollison
Payercast S01 E01 - Reviewing Price Transparency Rules and Exploring a Machine Readable File (MRF)
Payercast 2 min read

Payercast S01 E01 - Reviewing Price Transparency Rules and Exploring a Machine Readable File (MRF)

In Payerset's debut Payercast episode, we explore healthcare price transparency mandates, the structure of machine-readable files, and practical applications for using this data effectively.

May 4, 2024 Joseph Tollison
Industry Insights 2 min read

Price Transparency Q1 2024 Update: Strides Forward and the Road Ahead

Enhanced data quality, compliance, and innovative use cases for Price Transparency as Q1 2024 comes to a close.

April 7, 2024 Thomas Miller
Navigating the Landscape of Oncology Diagnostic Pricing in the U.S. Northeast
Industry Insights 2 min read

Navigating the Landscape of Oncology Diagnostic Pricing in the U.S. Northeast

An insightful study using Payerset data to shed light on price variation for oncology diagnostics in the Northeastern U.S., empowering providers with transparency data.

April 4, 2024 Joseph Tollison
Locations for Health Plan Transparency in Coverage Machine Readable Files Now Publicly Documented
Parsing Payer MRFs 1 min read

Locations for Health Plan Transparency in Coverage Machine Readable Files Now Publicly Documented

Payerset is now publicly documenting the location of all health plan Machine Readable Files (MRFs) to enhance transparency compliance and serve as a valuable public resource.

January 28, 2024 Joseph Tollison
Uncovering the Future of Price Transparency: A 2023 Recap and 2024 Outlook
Industry Insights 2 min read

Uncovering the Future of Price Transparency: A 2023 Recap and 2024 Outlook

A reflection on key price transparency milestones achieved in 2023, including improved payer compliance, data accuracy breakthroughs, and the outlook for practical data application in 2024.

January 6, 2024 Joseph Tollison
Industry Insights 3 min read

Peeling Back the Layers of Health Plan Price Transparency: A Journey Towards Democratized Data

Insights into the hidden complexities of healthcare price transparency data, from messy contract structures and rate stuffing to the path toward democratizing this critical information.

November 20, 2023 Joseph Tollison
November 2023: A Landmark Month in Health Plan Price Transparency
Parsing Payer MRFs 2 min read

November 2023: A Landmark Month in Health Plan Price Transparency

A look at the unprecedented growth in price transparency data during November 2023, including Elevance achieving zero corrupted files and United adding 200 billion rows of data.

November 18, 2023 Joseph Tollison
Parsing Payer MRFs 2 min read

A Turning Tide: How Major Payers are Stepping Up Their Data Game

A look at how major payers like Aetna, United, and Elevance are improving their price transparency data quality and accessibility.

November 13, 2023 Thomas Miller
Industry Insights 2 min read

Price Transparency Data: A Game-Changer for Health-Tech

How price transparency data is revolutionizing health-tech by empowering consumers to negotiate fair hospital bills and driving innovation across healthcare.

November 6, 2023 Thomas Miller
From Data to Decisions: Payerset's Path in Demystifying Price Transparency
Industry Insights 2 min read

From Data to Decisions: Payerset's Path in Demystifying Price Transparency

An overview of the diverse use cases emerging for price transparency data across hospital systems, benefits navigation companies, payers, and specialty clinics.

October 24, 2023 Joseph Tollison
Parsing Payer MRFs 2 min read

The Parse Oscar Goes To...

A lighthearted look at the most challenging payer price transparency files to parse, awarding 'Parse Oscars' to Elevance, Aetna, and Humana for their creative approaches to data publishing.

October 23, 2023 Thomas Miller
And Then There Was Humana...
Parsing Payer MRFs 3 min read

And Then There Was Humana...

An exploration of the unique challenges Humana presents for healthcare price transparency data access, from nearly 12 million individual files to API rate limiting and processing hurdles.

May 27, 2023 Joseph Tollison
Payerset and Snowflake: Powering Data Transparency in Healthcare
News 2 min read

Payerset and Snowflake: Powering Data Transparency in Healthcare

Announcing Payerset's listing on the Snowflake marketplace, making payer price datasets more accessible and fostering improved decision-making in healthcare.

May 27, 2023 Joseph Tollison
Aetna's Price Transparency & Thwarting Web Scraping to Keep Data Under Wraps
Parsing Payer MRFs 2 min read

Aetna's Price Transparency & Thwarting Web Scraping to Keep Data Under Wraps

Exploring the various techniques Aetna employs to block web scraping technologies, hindering data accessibility for consumers and other stakeholders.

March 2, 2023 Thomas Miller
Anthem Blue Cross Blue Shield's Data Obfuscation: The 180GB Table of Contents
Parsing Payer MRFs 2 min read

Anthem Blue Cross Blue Shield's Data Obfuscation: The 180GB Table of Contents

How Anthem BCBS made their price transparency table of contents over 180GB uncompressed and the techniques they employed to replicate data, creating barriers to accessibility.

February 10, 2023 Joseph Tollison
Navigating the Maze: How Insurance Companies Found Loopholes in Data Transparency Laws
Industry Insights 3 min read

Navigating the Maze: How Insurance Companies Found Loopholes in Data Transparency Laws

Exploring how some insurance companies technically comply with price transparency laws while making data virtually inaccessible, and what can be done to encourage meaningful transparency.

January 3, 2023 Thomas Miller
The Power of Data Transparency: Unlocking Benefits for Consumers, Health Systems, and Insurance Companies
Industry Insights 3 min read

The Power of Data Transparency: Unlocking Benefits for Consumers, Health Systems, and Insurance Companies

Exploring how data transparency laws benefit consumers, health systems, and insurance companies by empowering informed decisions, fostering competition, and promoting accountability.

December 7, 2022 Thomas Miller