Federal hospital price transparency rules went into effect in 2021. Four years later, hospitals across the country — including the four largest hospitals in the Texas Medical Center, as assessed in a new Baker Institute brief — still aren’t complying. On this episode of “Baker Briefing,” Vivian Ho explains why opacity in pricing is a key driver of rising health care costs and what policymakers can do to tackle the problem.

Mentioned in this episode: 

Derek Jenkins, Sasathorn Tapaneeyakul, and Vivian Ho, “Prices Versus Costs: Unpacking Rising US Hospital Profits,” Rice University’s Baker Institute for Public Policy, September 6, 2024.

Lunna Lopes et al., “Americans’ Challenges With Health Care Costs,” KFF, March 1, 2024, https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/.

Shameek Rakshit et al., “The Burden of Medical Debt in the United States,” Peterson-KFF Health System Tracker, February 12, 2024, https://www.healthsystemtracker.org/brief/the-burden-of-medical-debt-in-the-united-states/.

Sebastian Spataro Solorzano, Blake Davidson, and Vivian Ho, “Revisiting Price Transparency at Texas Medical Center Hospitals,” Rice University’s Baker Institute for Public Policy, April 29, 2025.

You can follow @BakerInstitute on X, Instagram, LinkedIn, and YouTube. Learn more about our data-driven, nonpartisan policy research and analysis at bakerinstitute.org.

Additional sources for this episode:

American Hospital Association, Trend Watch Chartbook 2018: Trends Affecting Hospitals and Health Systems (2018), https://www.aha.org/system/files/media/file/2022/11/2018-TrendWatch-Chartbook-Full.pdf.

Zach Cooper et al., “The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured,” The Quarterly Journal of Economics 134, no. 1 (February 2019): 51–107, https://doi.org/10.1093/qje/qjy020.

Health Affairs, “The Role Of Administrative Waste In Excess US Health Spending,” October 6, 2022, https://www.healthaffairs.org/content/briefs/role-administrative-waste-excess-us-health-spending.

• Salpy Kanimian and Vivian Ho, “Why Does the Cost of Employer-Sponsored Coverage Keep Rising?,” Health Affairs Scholar 2, no. 6 (June 2024), qxae078, https://doi.org/10.1093/haschl/qxae078.


• Lunna Lopes et al., “Health Care Debt in the U.S.: The Broad Consequences of Medical and Dental Bills,” KFF, June 16, 2022, https://www.kff.org/report-section/kff-health-care-debt-survey-main-findings/.


• Anne Martin et al., “National Health Expenditures in 2023: Faster Growth as Insurance Coverage and Utilization Increased,” Health Affairs 44, no. 1 (2025): 12–22, https://doi.org/10.1377/hlthaff.2024.01375.


• Anu Singh, “Hospital and Health System M&A in Review: Financial Pressures Emerge as Key Driver in 2023,” Kaufman Hall, January 18, 2024, https://www.kaufmanhall.com/insights/research-report/2023-hospital-and-health-system-ma-review.


• Laura Tollen, Elizabeth Keating, Alan Weil, “How Administrative Spending Contributes to Excess US Health Spending,” Health Affairs, February 20, 2020, https://www.healthaffairs.org/content/forefront/administrative-spending-contributes-excess-us-health-spending.