AJMC December 9, 2025
Key Takeaways
- Aetna and Cigna’s TIC data generally matched or exceeded their reported provider counts, while UnitedHealthcare listed fewer providers.
- Physician and hospital outpatient data were more complete than inpatient data, with significant variation across payers.
- CMS should audit TIC data completeness and enforce penalties for non-compliance to improve data quality.
- TIC data offer valuable opportunities for research and policy, despite current limitations in data completeness.
In analyzing 2025 Transparency in Coverage (TIC) files from national insurers, the authors found vast payer-level differences; overall, physician/outpatient data were more complete, and hospital inpatient data were less complete.
ABSTRACT
Objectives: To assess payer-level completeness of 2025 Transparency in Coverage (TIC) negotiated-rate files for physician, hospital outpatient, and hospital inpatient service...
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