As healthcare nears the five year publication anniversary of the first machine-readable files (MRFs), it remains evident that price transparency data is incredibly useful. For a long time, the only way to report on that usefulness was to focus on files and rates posted. This was a good start on measuring quality, but as we head into 2026, the maturing data and our improved processes allow us to measure additional metrics. When focusing on the payer transparency files today, we go beyond the number of negotiated rates posted by a payer and assess which files and rates are complete, accurate, and useful.
Payers have similar mandates in the price transparency laws as providers, requiring them to publish comprehensive in- and out-of-network rates for all items and services since July 1, 2022. Since that summer of ‘22, we at Turquoise Health parse a petabyte of reported payer rates each month and have made that information available to the industry and consumers. A once bold experiment, price transparency has deftly matured into a core component of the healthcare transaction and served as the foundation of a new contracting ecosystem. The same payers and providers that may have been wary of the data’s value now rely on price transparency data as an essential tool for negotiation and market intelligence.
To measure the success of price transparency mandates over time, entities like Turquoise have dedicated countless hours to reporting on payer rates posted. However, until recently, given the complexity of files, the industry has struggled to comprehensively report on payer data quality. Now with our newly published Payer Transparency Scores, we’re able to do just that. The publicly-available Payer Transparency Scores evaluate the quality and completeness of payer-reported files, offering the first standardized way to assess payer-reported data’s completeness and usability. To bring the score insights to life, we also published a 2025 Impact Report, offering a State of Price Transparency today, surfacing insights across payer scores, national payer specific analysis, policy updates, and more. At a high level, we have scored 97 payers, including United Healthcare, Cigna, Aetna, and Anthem, our reporting found that 91% of payer profiles reviewed passed the technical bar for CMS schema compliance with 94% of payers highly parsable and only 29% of payers with >50% conflicting rates. We continue to add new payers to the dashboard and refresh the scores monthly.
Now, industry stakeholders can evaluate not only payer MRF completeness, but also how usable that data is for practical decision-making. By scoring completeness, consistency, and rate reasonableness (aka, a measurement of what proportion of rates are outliers), Payer Transparency Scores help hospitals, analysts, and reporters alike identify high-fidelity data they can trust while surfacing opportunities for file improvement that might otherwise go unnoticed.
Even more importantly, payers themselves can use the scores to improve the quality and accuracy of their own files, exploring performance on an individual hospital/ASC basis. Although we created these Payer Transparency Scores, Turquoise Health is not the arbiter of compliance. According to Transparency in Coverage, only the states or the Department of Health and Human Services (HHS) can review a payer MRF and deem it compliant or noncompliant At the time of writing, no payer files have been publicly identified by HHS as noncompliant. However, on October 1, CMS’ TiC GitHub repository was updated with payer schema version 2.0 requirements, indicating that payers may soon face official scrutiny on their files. The schema changes are tactical and point to a longer road of continual improvement in the data displayed in payer MRFs. This will be the first time payer MRF generation teams will have to meaningfully study the requirements, make process changes, and run new quality assurance checks since establishing a process based on the first TiC schemas. Notably, the October 1 updates did not include a due date for the third Prescription Drug file, which remains on hold indefinitely.
We’ve built this for the entire industry—helping all stakeholders move toward a more transparent, higher-quality healthcare data environment. Our CEO, Chris Severn, likes to say sunlight is the best disinfectant. When everyone can see the same objective measure of data quality, we can collectively raise the bar for utility, accountability, and enforcement. Ultimately, that improved data landscape will be foundational to eliminating the financial complexity of healthcare.
Payer Transparency Scores will refresh monthly through a public-facing interface.
About Turquoise Health: Turquoise Health helps mission-driven leaders confidently bring their organizations into the modern age. As healthcare’s most trusted price transparency company, Turquoise enables precision pricing and intelligent contracting on a platform built for finance teams across the industry. A firm believer that healthcare can change, Turquoise is building the not-so-distant future where prices are upfront and payments are bundled.
Carol Skenes
Carol Skenes is Chief of Staff at Turquoise Health.
