A push for CMS enforcement could accelerate pressure on MA plans to publish complete negotiated rate data, giving providers better leverage in contract negotiations.
Price Transparency With Gaps: Assessing the Completeness of Payer Transparency in Coverage Data
Aetna and Cigna generally listed as many—or more—physicians and hospitals as their marketing materials did, whereas UnitedHealthcare listed fewer. Negotiated-rate completeness was highest for physician specialties and lowest—often minimal—for inpatient files. UnitedHealthcare’s physician groups were near complete, but inpatient data were sparse. For these payers, 2025 TIC files support analysis of physician and hospital outpatient prices but are inadequate for inpatient benchmarking. CMS should evaluate TIC completeness—internally or via an external auditor—and enforce penalties when required information is not published.
— American Journal of Managed Care, December 9, 2025
Muhlestein, David B., and Yuvraj Pathak. “Price Transparency With Gaps: Assessing the Completeness of Payer Transparency in Coverage Data.” American Journal of Managed Care, 9 Dec. 2025. https://www.ajmc.com/view/price-transparency-with-gaps-assessing-the-completeness-of-payer-transparency-in-coverage-data.
Insurers Not Fully Complying With Price Transparency Rules: Study
Insurers are publishing incomplete price transparency data, with hospital inpatient information particularly sparse, according to a study published in the American Journal of Managed Care in December.
— Becker’s Payer Issues, December 11, 2025
Big Insurers Provide Incomplete Transparency Data: Study
Three of the nation’s biggest health insurers have provided an incomplete picture of their negotiated prices in transparency data that’s required by federal rules, according to a new analysis. The partial disclosures by UnitedHealthcare, Aetna and Cigna could leave employers in the dark when shopping for workplace coverage, per the analysis in the American Journal of Managed Care.
— Axios, December 11, 2025
Supplemental Analysis
Payer Price Transparency Scores Reveal Wide Data Quality Gaps: 10 Notes
Turquoise Health now tracks 219 payer files monthly. The company has assigned transparency scores to 97 payers to date, with plans to continue expanding coverage. The scores evaluate parsability, conflicting rates, and outlier rates. Conflicting rates remain the most pervasive data quality issue. Turquoise defines conflicting rates as instances where a single service has multiple distinct rates reported with no discernible way to differentiate between them. Of the 97 scored payers, 28 (29%) have at least 50% of their rates marked as conflicting.
— Becker’s Payer Issues, December 12, 2025
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