Home Health Care Navigating the Challenges of Price Transparency: Highlights from ViVE

Navigating the Challenges of Price Transparency: Highlights from ViVE


From left: Ben Leonard of Politico; Tina Barsallo of Lifepoint Health; Dr Eve Cunningham of Providence; Niall Brennan of Clarify Health; and Dr Prabhjot Singh, of Peterson Center on Healthcare

The ViVE conference in Nashville, powered by HLTH and CHIME, offered an overview of the latest developments in health tech spanning interoperability, cybersecurity, price transparency, behavioral health and health equity. Micky Tripathi, the head of the Office of the National Coordinator, provided a progress report on interoperability. A panel discussion highlighted some of the challenges associated with price transparency. In response to the healthcare industry’s anxiety over cybersecurity risks, industry experts discussed what threats to anticipate and how to address them.   

The challenges of price transparency 

Transparency and interoperability were prominent themes at the ViVE conference. The Transparency in Coverage Rule requires plans to make price comparison data available for 500 items and services this year. In 2023, health plans have to expand price transparency so that price comparisons can be made to all covered services. In the panel discussion at the ViVE conference, Running Up that Hospital Bill, panelist Niall Brennan, chief analytics and privacy officer with Clarify Health, criticized the way the rule was written, observing that some payers use different tactics for getting around the rule and game the system with “zombie rates”.  

“There’s a lot of what we call ‘zombie rates’ in the data,” Brennan said. “Payers post rates for services that would never happen in a million years such as spinal surgery rates for clinical labs, and different things like that. And they were also posting the same rate over and over again for every single third party administrator (TPA) contract they had… I wish that [the rule] had been approached in a slightly different way.”

Another frustration is the public’s lack of awareness of these price transparency tools. Probhjot Singh, Senior Adviser with Peterson Center on Healthcare, pointed out that a recent report with Kaiser Family Foundation found that only a small percentage of Americans were aware they can obtain price comparison information for procedures despite the fact that some health systems have invested for years to build and implement price transparency software. 

Eve Cunningahm of Providence acknowledged that it took three years for the health system to develop software to enable the institution to be compliant. She also said that although price transparency rules are unlikely to bring down the cost of healthcare, they could help patients avoid sticker shock for non-emergency healthcare needs, which could improve the patient experience.

“The patient financial journey today is horrible. Patients don’t know how much things are going to cost them and we have patients who go bankrupt. There are thousands of GoFundMe [campaigns] from patients trying to raise money to help pay for their hospital bills. We need to help them understand what that cost of care is going to be when they sign up for a health insurance plan. How do we help them understand what they’re getting themselves into when they have a health crisis or health situation or they have to make a decision about even an elective procedure?”

Beyond the panel discussion, tools to support price transparency were on display from companies such as Serif Health, a health tech vendor that developed software to help the healthcare industry access price transparency data through an API.  The API enables provider groups and digital health companies to integrate price transparency data into their in-house solutions.

Matthew Robben, Serif Health CTO and co-founder, acknowledged that claims repricing is a contentious issue. The fastest growing segment of its customer base is currently self-insured employer groups who want to find out if they are overpaying for healthcare.

“We’re starting to see lawsuits by self-insured employers who need data from payers so they can meet their fiduciary responsibility to plan members,” Robben said 

Regulatory updates

Micky Tripathi, the national coordinator for health IT, offered a regulatory update on three fronts: building a digital foundation, making interoperability easier, and encouraging information sharing

He noted that the pace of updates for the U.S. Core Data for Interoperability (CDI) — a standardized set of health data classes and data elements for nationwide, interoperable health information exchange— had quickened from every four years to every year, much to the consternation of those in the healthcare industry who struggle to keep up with implementing these changes. The draft for the fourth update is currently available for public comment until April 17. Tripathi added that the ONC is preparing to launch a U.S. CDI for cancer in coordination with the National Cancer Institute.

Turning his attention to interoperability, Tripathi noted that the healthcare industry has made considerable progress on FHIR APIs with certified vendors able to make APIs available to their healthcare industry customers. He acknowledged that 30% of hospitals lack the resources to implement this technology.

Information blocking provisions of the 21st Century Cures Act went into effect in October 2022. Enforcement will come into play later this year when the Office of the Inspector General issues the draft of the rule in September.

Casting an eye on health equity, Tripathi said the ONC is striving for greater consistency for capturing health equity data.

Virtual reality and behavioral health

BehaVR, a digital therapeutics company, highlighted virtual reality software for the intersection of physical therapy, chronic pain management, and mental health.

Developed in collaboration with Confluent Health, the software addresses the challenge of how to help people recovering from a physical injury regain range of motion. It uses an immersive game to help them get over the fear of triggering pain from certain movements. Users have to use arms and handheld console to either shoot targets or bridge connections between targets depending on patients’ needs. Although it has 150 physical therapy provider customers, the goal is to expand to more providers and payers this year. The game platform is based on a body of pain neuroscience research from Adriaan Louw on the cognitive processing of pain. 

BehaVR merged with Oxford VR in December 2022 and closed a $13 million Series B round led by Optum Ventures and Oxford Science Enterprises, with participation from Confluent Health, Accenture Ventures, Chrysalis Ventures and Thornton Capital.

The merger follows a collaboration deal with Japanese pharma company Sumitomo Pharma signed in 2021 to develop and commercialize prescription digital therapeutics and general wellness products covering treament of social anxiety, generalized anxiety and depression. BehaVR Founder and CEO Aaron Gani previously served as CTO with Humana.


Errol Weiss, Chief Security Officer for Health with Health ISAC presented some of the findings from its latest cybersecurity report at the Cybersecurity Pavilion. He drew attention to a new trend in phishing that he referred to as call back phishing.

He noted that some cybercriminals have figured out that if they can get targeted people at a company to call them back, they can walk them through how to install malware by duping the target into thinking they are actually installing software to protect their computer. In some cases, the email only has a phone number to call.

Looking ahead, Weiss observed that remote patient monitoring increases cybersecurity risks because it increases the surface area at risk. He also cautioned that Chat GPT and Google Bard pose cybersecurity risks to healthcare organizations because bad actors could use them to fine tune their cyber attack strategies.

Following his presentation, Weiss noted that smaller hospitals, which rarely have a full time IT department, could focus on using patching to back up data.

“Working groups are sharing best practices and templates for internal procedures. We’re big advocates for a partnership approach between providers and business associates as opposed to contentious relationships.”

Partnerships to support startups

Startups were prominent at the conference, particularly with the support of larger organizations such as AARP, MATTER, StartUp Health, and Nashville’s healthcare entrepreneurship initiative Project Healthcare.

ScaleHealth, an exhibitor at ViVE that hosted several startups in its network, announced a partnership with the Philadelphia-based University City Science Center to support recruitment for the Science Center’s Capital Readiness Program.

The Science Center is currently accepting applications for the second cohort. It’s the first time they have worked with ScaleHealth to source companies locally and globally. CRP is a one-week intensive that offers direct feedback and due diligence review by strategic partners and active investors, according to a statement from the Science Center.

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