Understanding the New Executive Order on Healthcare Price Transparency
In February 2025, President Trump signed an executive order to increase healthcare price transparency. The order was issued in response to rising healthcare expenses and limited competition in the market, which have made it tough for patients and providers to access clear pricing information.
While the order impacts both healthcare organizations and payers, the payer transparency requirements in particular could lead to improved contract negotiations and financial performance.
Summary of the 2025 Executive Order
The executive order introduces several requirements that will make healthcare pricing more transparent and competitive.
Payer Disclosure of Negotiated Rates
Payers are now required to disclose the actual negotiated rates they have with healthcare providers, not just estimated costs.
Accessibility and Standardization
The order mandates that pricing information be provided in a clear, easy-to-understand format. This includes both service and prescription drug costs.
Stronger Enforcement Measures
Payers have about three months to make the required adjustments. Federal agencies have been given 90 days to establish penalties for non-compliance.
This new level of payer transparency puts pressure on insurers to offer more competitive rates; at the same time, it makes it easier for healthcare organizations to identify and challenge underpayments. One economic analysis found that increased transparency could reduce healthcare costs by up to $80 billion.
Why Payer Transparency Matters
While the executive order affects both healthcare organizations and payers, the requirements for payers are most notable. For the first time, organizations will be able to actually see what payers are reimbursing their competitors for identical services.
This means that organizations can now identify inconsistencies in how different payers reimburse for the same services rendered. And by doing so, they can negotiate higher rates with underperforming payers.
In this same vein, access to market-wide payer data lets healthcare organizations establish reasonable benchmarks for reimbursement rates. This makes it harder for payers to justify below-market compensation.
Finally, healthcare organizations can now build data-driven cases for rate increases. In other words, they can base future increases on market rates instead of vague claims about “standard” reimbursement levels.
How Trek Health Can Support Compliance
The influx of complex payer data is overwhelming for most healthcare organizations to process on their own. Trek Health aggregates and organizes this payer-specific data, which gives healthcare organizations a clear view of how their rates compare across different payers and against competitors.
To help organizations identify reimbursement gaps, we process over 300 terabytes of payer data each month, including more than 500 billion negotiated rates. Our platform consolidates payer data from across the industry, by identifying inconsistencies and gauging rates against competitor contracts. This helps healthcare organizations present hard data when negotiating rates with payers, and avoid relying on estimates or incomplete information.
For example, we identified a 500% variance in reimbursement rates for a routine 30-minute doctor’s visit in San Francisco. One provider was reimbursed $660, while another was reimbursed only $101 for the same service. Trek Health sees these situations regularly and can support organizations fully in such scenarios. We give clients the insight they need to secure a better rate.
Challenges and Opportunities
The February 2025 executive order presents both challenges and opportunities for healthcare organizations. In terms of challenges, organizations must quickly adjust to high volumes of newly available payer data. Without a system in place to organize and analyze this payer-specific information, providers could lose out on opportunities to improve their contract terms.
Trek Health helps with this by automating the payer data analysis process. Our ability to clean and consolidate complex payer information lets healthcare organizations focus on strategy instead of spending their time sorting through complicated rate files. Healthcare organizations that move fast to analyze and act on this new payer data will be in a better position to work the new payer transparency requirements to their advantage.
Here again, the opportunity is in our clients’ ability to negotiate better rates with payers. Providers that have access to this new level of payer data can push back on low reimbursement rates and secure better terms. Trek Health’s payer benchmarking and modeling capabilities give healthcare organizations the leverage they need to negotiate, and do it well.
Why Healthcare Organizations Should Act Now
Providers that adapt quickly to the payer transparency requirements laid out in the February 2025 executive order will have an edge in securing better rates and improving their financial performance. Trek Health gives healthcare organizations the tools they need to capitalize on this opportunity.
Our platform’s data analysis capabilities give early adopters a leg up in the market. Healthcare organizations that wait to take advantage of the new payer transparency requirements risk losing ground to competitors that move faster.
So what do you say? Learn how Trek Health can help you secure better contract terms with payers today. Book a free demo to see how your organization can use real-time payer data to maximize reimbursement rates and increase your bottom line.
