Exploring Implementation of The Medicare Price Transparency Rule (2025-2026)

Real-time benefit tools (RTBTs) are applications embedded in electronic health records that provide individualized cost estimates for prescription medications and suggest lower-cost alternatives (e.g., same drug at a different pharmacy or a less expensive medicine in the same class, like a generic). 

When clinicians use these tools, patients are more likely to fill prescriptions and their out-of-pocket costs decline. Federal regulations have pushed for increased implementation, and Medicare Part D plans are now required to provide accurate cost estimates for medications to RTBTs. Starting in 2028, all electronic health records will be required to include an RTBT in their base product. Despite this, little is known about the experiences of health systems implementing these valuable tools.

Team members interviewed health systems leaders to understand the challenges of implementing RTBTs. They examined which processes are effective and which require further refinement, with the goal of informing future policy development.

The team found that incentives for health systems to adopt RTBTs included decreasing out-of-pocket costs for patients, increasing medication adherence and streamlining clinician workflows. Health system leaders were generally in favor of point-of-care, out-of-pocket price transparency, but RTBT adoption and sustained use by clinicians requires trust, training and data transparency.

Timing

Summer 2025 – Summer 2026

Team Outputs

Health Systems' Experiences Implementing a Drug Price Transparency Tool: A Qualitative Study (Poster presentation at the Fortin Foundation Bass Connections Showcase, April 15, 2026)

Health Systems' Experiences Implementing a Drug Price Transparency Tool (Team profile)

Health Systems' Experiences Implementing a Drug Price Transparency Tool (Poster presentation at the AcademyHealth Annual Research Meeting; Seattle, WA; May 30–June 2, 2026)

Health Systems' Experiences Implementing a Drug Price Transparency Tool (Oral presentation at the Society of General Internal Medicine (SGIM) Annual Meeting; Washington, DC; May, 2026)