Recent CMS proposals to update price transparency requirements have generated a familiar question: If the government is making health care prices easier to disclose, will tools for price transparency still be necessary? The short answer is  yes — arguably more than ever . The proposed changes are meaningful and welcome. But they do  not  make health care pricing simple, self‑explanatory, or easily consumable by the average employer, provider, or patient. What they do instead

In this episode, Jarvis T. Gray welcomes Maria Nikol, Founder of Revelar Analytics, to discuss the evolving landscape of price transparency in healthcare, value-based care, and the journey of healthcare entrepreneurship. Maria Nikol shares insights from her 15+ year career, spanning consulting, working with payers, health tech startups, and building a company dedicated to simplifying fair market value for medical services. The conversation dives deep into personal leadership

Starting  January 1, 2026 , new rules from Centers for Medicare & Medicaid Services (CMS) will require hospitals to publish far more detailed — and consumer-friendly — pricing information. [1] These changes build on earlier transparency efforts (which first took effect in 2021) that required hospitals to post “standard charges” including gross charges, negotiated rates, cash-pay discounts and other baseline pricing data. [2] The 2026 update significantly raises the bar, aimi

Assuming you’ve watched “What is price transparency” in which I discussed the Transparency in Coverage rule issued by CMS, I’m going to dive into the final rule. On a public website, plans and issuers are now required to disclose their in-network negotiated rates, billed charges, allowed amounts paid for out-of-network providers, and the negotiated rate and historical net price for prescription drugs. Click to watch our explainer video here: https://youtu.be/2CNe4Z5Zre8

In today’s healthcare conversations, the term price transparency is used in different ways. It’s important to know that there are two major rules that govern price transparency: The Hospital Price Transparency Rule and the Transparency in Coverage, which were both issued by CMS. Listen to our brief explainer video here! https://youtu.be/TJxmZSDk284

Jackie Selby, Partner, Epstein Becker & Green PC, Maria Nikol, CEO, Revelar Analytics LLC, and Karen Mandelbaum, Senior Counsel, Epstein Becker & Green PC, discuss current trends and developments related to price transparency. They cover why price transparency is important; provide an overview of the hospital transparency rule and the transparency in coverage rule for health plans; and detail how the rules are impacting providers, payers, and consumers. Jackie, Maria, and Kar

For almost 70 years, employers have been the primary source of health care coverage for Americans under the age of 65. Employers receive incentives for offering health insurance and other benefits to employees under the Internal Revenue Service (IRS) Tax Code. Originally, health insurance only covered hospital and surgical procedures; physicians were only reimbursed for the services they provided when patients were hospitalized, as hospitalists were not introduced until the 1

Originally published on: https://salienthealth.com/price-transparency-data-analytics-healthcare/ Healthcare analytics providers and price transparency vendors play complementary roles in advancing the efficiency and effectiveness of healthcare organizations. Analytics providers leverage data to uncover trends, optimize operational workflows and improve decision-making. Price transparency solutions focus on making reimbursement costs and payouts clear and accessible to provide

On May 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released two important updates to Medicaid regulations. The new Medicaid Access Rule [1] and Medicaid Managed Care Rule [2] introduce updated requirements for both states and Medicaid managed care organizations. These rules are designed to improve and standardize how Medicaid services are reported, monitored, and evaluated, ensuring better access to care for beneficiaries. One of the key provisions is to ha

At Revelar Analytics, we understand that the cornerstone of informed decision-making in healthcare is data comprehension. Our team of dedicated analysts leverages innovative proprietary technology to provide our clients with unparalleled price transparency capabilities.   Throughout 2024, Revelar assisted organizations around the country in identifying opportunities by providing them with software and consulting services that enabled them to shape their strategy by using our

The rise of price transparency is rapidly reshaping the healthcare analytics landscape in multiple ways. It is quickly becoming a transformative factor for provider organizations looking to negotiation their payer contracts, including hospitals, managed care entities, large specialty clinics, and private practices. By increasing access to pricing information, it introduces a new perspective on fair market value—an area previously guided by either Medicare percentages or surve

At Revelar Analytics, we understand that data comprehension is the cornerstone of informed decision-making in healthcare. Our team of dedicated analysts leverages innovative proprietary technology to provide our clients with unparalleled price transparency.   Throughout 2024, Revelar assisted organizations around the country in identifying opportunities using our data by providing them with software and consulting services that enabled them to shape their strategy.   Today, w

Ryan Mackman recaps his presentation on price transparency and value-based care at BRI Network’s 2024 Value-Based Healthcare Congress.

Learn how price transparency helps providers optimize pricing, negotiate better rates, and succeed in value-based care models.

Maria Nikol, CEO of Revelar Analytics, discusses price transparency's transformative role in healthcare on Planetary Health First podcast.

Explore the Price Transparency Rule’s challenges and how Revelar Analytics turns complex payer data into actionable insights.

Revelar’s Adam Kern and Maria Nikol share price transparency insights at the National Healthcare Transparency Summit. Learn more today!

Maria Nikol, Revelar Analytics CEO, discusses price transparency, value-based care, and healthcare innovation on 'Health Innovation Matters"

Maria Nikol, CEO of Revelar Analytics, discusses price transparency and value-based care innovation on the 'Approaching Infinity' podcast.

Leverage the Price Transparency Rule to access pricing data, negotiate fair rates, build networks, and align incentives with Revelar.