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For Health Plan and TPA leaders, the regulatory era of transparency has set the stage for a competitive battleground. Compliance alone was never a differentiation strategy. To truly compete in the market and gain a competitive edge, price transparency data must be expertly curated, integrated, and delivered. TALON’s platform transforms raw machine-readable file (MRF) data…

Reference-Based Pricing (RBP) has long been positioned as a solution to rising healthcare costs by anchoring reimbursements to a benchmark of Medicare. While it can generate near-term savings, RBP is plagued by volatility, provider abrasion, member balance billing, and administrative overhead. TALON’s Universally Acceptable Payment Amount (UAPA) offers a more sustainable alternative. UAPA is a…

“A hero is someone who has given his or her life to something bigger than oneself.” – Joseph Campbell   The Wall Street Journal just rang the bell: employer health insurance costs are projected to jump nearly 10% in 2026 — the steepest rise in 15 years. This is the call to adventure for every…

In part 1 of this series, “The Year of Healthcare Consumerism”, we defined the current state of healthcare price transparency, a critical piece of the healthcare consumer journey. We reviewed the current regulations requirements, enforcement and oversight, and gaps and opportunities within the market. In part 2 of this series, we’ll be reviewing the very…

In part 1 of this series, “The Year of Healthcare Consumerism”, we’ll be defining the current state of healthcare price transparency, a critical piece of the healthcare consumer journey. We’ll review the current regulations requirements, enforcement and oversight, and gaps and opportunities within the market. In a recent report published by Deloitte, it was noted…

For those not aware of what exactly second-order consequences are, it’s a model of thinking frequently referenced by Ray Dalio, founder of the very successful investment firm Bridgewater Associates. Below is a a great example of first and second order consequences  “For example, the first-order consequences of exercise (pain and time spent) are commonly considered…

In the next blog post within the TALON price transparency series, we will highlight why incorporating healthcare price transparency data will provide competitive insights and symmetrical information in the market for all key stakeholders. Introduction to Blog Series: Transparency in healthcare pricing has finally arrived with the passage of January 1st, 2024. The series of…

Introduction to Blog Series: Transparency in healthcare pricing has finally arrived with the passage of January 1st, 2024. The series of actions that have led us to this point goes as far back as the implementation of the Affordable Care Act, but more recently include the implementation and enforcement of the Hospital Transparency Rule, the…

It’s Finally Here. The moment we’ve all prepared for—or have we? The simple fact is that when the second phase of the Transparency in Coverage Rule was rolled out on January 1, 2023, requiring plans to provide members with an online pricing tool containing easily accessible cost-sharing information for a list of 500 services, software…

As we close another year and look ahead to the final rollout phase of the Transparency in Coverage Rule (TiC), it’s the perfect time to reflect on what has been accomplished. It’s been a long and tedious process of implementing all three phases of TiC across health plans and insurance issuers in individual and group…