Pricing transparency has been an issue in the US for 100+ years. Not since families traded a chicken for a house visit in the early 1900s has pricing really been clear – and today’s insurance environment has worsened the confusion. Pricing differences are especially important for the 1 in 12 Americans who don’t have health insurance.
But we are making progress. In 2019, the U.S. government mandated that hospitals provide clear pricing details for procedures, and while not all hospitals are yet in compliance, many are. In March 2025, the White House issued a new presidential action under the mantle of Making America Healthy Again, doubling down on its 2019 initiative with a new proclamation on Empowering Patients with Clear, Accurate and Actionable Healthcare Pricing Information.
What I have seen firsthand from working with providers is that most already have access to all the data they need to educate patients about insurance verification, prescription pricing and pharmacy choice on the spot during appointments – but they often don’t access it or share it with patients. Forward-thinking providers are taking a proactive approach to providing patients with these details during office and telehealth visits. Those that do have told me that when patients are equipped with this information, they are more likely to schedule follow-up care, fill their prescriptions and adhere to a medication schedule. Patients can save an average of $600 per year.
So why are providers – and to some extent, payers – withholding these details from patients, even though they know it would save patients money and improve care?
The chief reason is likely time. Many providers feel pressured to spend less time with patients, not more. Reviewing medication pricing and availability details with patients during a visit may feel impractical, even though the benefits are proven and measurable. Clinical staff often don’t feel like they have time to serve as financial counselors to patients. They may also feel that the pricing data they have requires some translation so that patients can clearly understand their options.
The simple solution: equip other clinical or administrative staff with the data readily available through e-prescribe platforms – and train them to review it with patients. E-prescribing software is already in use in the vast majority of practices, making accessing this information easier than it ever was.
In just a few minutes, medical staff can:
– Verify that a medication is covered by the patient’s insurance, and update the prescription (to a generic or substitute) if needed
– Check availability of the medication at local and mail-order pharmacies
– Price shop the medication at those pharmacies
– Submit the prescription to the patient’s chosen pharmacy
A national survey found that 33 percent of Americans don’t fill their prescriptions, and the top reason (30 percent) is cost. Other top reasons are the patient simply forgot (18 percent), medication is out of stock (17 percent), or the patient can’t get to the pharmacy (17 percent).
Taking a few minutes at the end of a visit to ensure a patient can afford and acquire their medication could eliminate all of these concerns, boosting medicine adherence and quality of care. It would be time well spent.
Learn how DoseSpot is providing complete price transparency with their Total DoseSpot Solution.
