Health care pricing transparency

In an era of rising health care costs and consumer-driven financing alternatives, the need for health care cost transparency solutions has become increasingly important. Consumers demand information about their health care fees, and regulatory measures will continue to drive this need. In order to stay competitive, as well as responsive to market and patient needs, health care organizations like yours should embrace this movement and launch a comprehensive pricing transparency strategy. The cornerstones of this strategic effort include weighing procedure costs, managed care and market risk. The professionals at RSM are poised to help you through all phases of this strategic implementation.

Our approach
Our consultants begin by working with you to establish a rational pricing methodology by rebasing charges for items and services within your organization. Next steps include: 

  • Evaluating the range and relative defensibility of current Department of State markup factors
  • Evaluating multiple scenarios, narrowing and widening cost corridor guardrails, while assessing gross and net revenue implications
  • Analyzing short-term net revenue needs while transitioning to a more defensible, cost-based pricing methodology

A managed care analysis requires intimately understanding payer agreements and payment methodology-related opportunities and risks presented by charge-sensitive contractual agreements. This provides an opportunity to evaluate longer-term revenue risk associated with accountable care incentives, declining utilizations and transparency-motivated charge reduction strategies. In addition, the analysis provides an opportunity to evaluate payer-specific charges and net revenue leakage risks and mitigation strategies.

For a closer look at the forces at play in the health care marketplace and how we can help your organization with price transparency, download our pricing transparency information sheet.

Also, to gain further information about RSM’s pricing transparency capabilities, read this helpful FAQ.

Most Popular Insights


Hospitals prepare for pricing investigation

According to the American Hospital Association, hospitals should be prepared for scrutiny related to health care pricing. Learn more.

  • November 21, 2017


HFMA National Institute—ANI 2016 presentation recap

Pricing transparency is a multiyear transformation and requires the engagement of many different stakeholders throughout the organization.

  • July 08, 2016


Case study: Florida Hospital

Read this case study to learn the strategies Florida Hospital used to transform its pricing strategy to meet patients’ growing needs.

  • June 16, 2016


Balancing transparency and revenue performance with rational pricing

Learn about the importance of establishing a pricing transparency methodology, as well as a rational pricing strategy.

  • Jim Sink
  • |
  • November 20, 2014

How can we help you?

To discuss how our team can help your business, contact us by phone 800.274.3978 or

Events / Webcasts


What is GASB 87 and how does it affect your organization?

  • January 28, 2020


Health care industry 2019–2020 webcast series

  • January 16, 2020


Senior Living PDPM webcast

  • June 19, 2019