For years, hospital systems have been able to buy independent physician practices and charge more for the same care.
The doctor, office, and service may be the same, but once a hospital owns the practice, the bill can suddenly include higher hospital charges.
President Donald J. Trump’s healthcare transparency reforms are beginning to challenge this broken incentive.
During his first administration, President Trump issued a price transparency executive order that forced institutions to begin revealing prices that had been hidden from patients and employers.
The current Trump administration has strengthened these requirements. Hospitals must provide more complete pricing information and include standardized provider identifiers in their public price files. The administration has also expanded Medicare’s use of physician-office-equivalent payments for certain services provided at off-campus hospital departments.
President Trump also signed legislation requiring off-campus hospital departments to obtain and use separate provider identifiers for Medicare billing beginning in 2028. This will make it harder to hide the actual location where care occurred behind the identity of a hospital’s main campus.
Now Elevance Health is showing what better information can enable.
The company announced that it will require hospitals to identify where care was actually provided, compare billing information with hospital addresses, pay certain off-campus services at the appropriate off-campus rate, and prevent higher hospital billing for certain laboratory tests performed somewhere else.
The policies will apply across Elevance’s commercial, Medicare Advantage, and Medicaid businesses.
This is what transparency should accomplish. It is not simply about posting files on government websites. It should allow patients, employers, insurers, and government programs to follow the money and challenge unjustified prices.
Elevance’s policy is not full site neutrality. The company has not shown that its off-campus rates will always equal the rates paid to independent practices. The policy also covers only certain services and Elevance-covered patients.
Congress should now finish the job.
When the same routine care can be provided safely in different settings, Medicare and its beneficiaries should not pay more simply because one location is owned by a hospital.
President Trump’s transparency agenda has begun exposing the information needed to challenge institutional pricing power. Elevance is demonstrating how that information can be used.
The next step is full site-neutral payment in Medicare: the same payment for the same routine care, regardless of who owns the building.
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