Currently submitted to: Online Journal of Public Health Informatics
Date Submitted: Jul 7, 2026
Open Peer Review Period: Jul 10, 2026 - Sep 4, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
State-Level Healthcare Price Transparency in the United States: Systematic Review
ABSTRACT
Background:
Healthcare price transparency initiatives have expanded across the U.S. since federal public rate disclosure requirements went into effect in 2021. However, state price transparency activity remains fragmented, uneven, and less understood.
Objective:
To describe state-level price transparency activity across key domains and identify gaps and opportunities in the development of more integrated price transparency systems.
Methods:
We conducted a scan of all 50 states and the District of Columbia using publicly available websites and coded documented activity across seven domains: hospital price transparency laws, insurer transparency requirements, drug pricing transparency, all-payer claims database (APCD) activity, state-sponsored transparency websites, market-led comparison tools, and transparency impact assessment.
Results:
We found that price transparency activity is fragmented across states. Among the domains we examined, we found that drug pricing transparency was the most common area, appearing in 46 jurisdictions, followed by hospital transparency laws and comparison tools in 42 each. APCD activity appeared in 36 jurisdictions, state-sponsored websites in 30, insurer transparency requirements in 28, and impact assessment in 11.
Conclusions:
State healthcare price transparency activity is widespread, but the availability of individual initiatives does not necessarily make price information accessible or actionable. States may increase the value of transparency by connecting disclosure requirements, data standardization, comparison tools, purchaser access, and routine evaluation into systems that patients, employers, policymakers, and other users can effectively use. Clinical Trial: N/A
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.