Solomon accepts no revenue from hospitals, health systems, or data vendors serving them.
The public records required under the federal transparency rule.
The Solomon Standard measures hospital prices against Medicare. Under 45 CFR Part 180, every hospital is required to publish a machine-readable file of its list prices, cash prices, and negotiated rates by payer. The Standard benchmarks each of these against what Medicare pays for the same service.
The measurement is applied state by state, hospital by hospital, service by service. A price above the Standard is not illegal. It is a measure of how far that price has moved from the nearest public reference point in American healthcare.
Indiana's House Enrolled Act 1004 requires the state's largest nonprofit hospital systems to offer employer contracts at or below 260% of Medicare. The Solomon Standard adopts this line as its national benchmark, not because it is the ideal price, but because a legislature defined it, and it gives every measurement a fixed, public line to be read against.
A benchmark is only useful if it is achievable. Findings from three states confirm that hospital pricing near Medicare is not theoretical.
| Evidence | × Medicare | Scope |
|---|---|---|
| SCAN Health Plan, California inpatient contracts, median | 1.12× | 3 hospitals |
| New York inpatient floor, lowest negotiated rate per DRG, median | 1.08× | 15 hospitals |
| Florida inpatient floor, lowest negotiated rate per stay, range | 1.06× to 1.73× | 51 hospitals |
SCAN Health Plan's California inpatient contracts pay a median of 1.12 times Medicare and never cross the 260% line. SCAN's California contracts are one of the Standard's founding market inputs.
In New York, at 12 of 15 hospitals with usable inpatient data, the lowest negotiated rate is set by a Medicare Advantage plan: Aetna, Anthem, Healthfirst, Fidelis, Independent Health, or Excellus, depending on the hospital. The median floor across all 15 hospitals is 1.08 times Medicare. The affordable inpatient rate exists at every one of these hospitals, in writing. It is the rate the hospital has agreed to with a Medicare Advantage plan.
In Florida, at 51 hospitals with a real floor, the lowest negotiated rate per stay sits between 1.06 and 1.73 times Medicare, a band that includes SCAN's 1.12. One plan, Clear Spring Health, sets the floor at 26 of the 75 hospitals with readable payer data.
Three states. Different payers. The same finding: hospitals already accept rates near Medicare from someone. Every one of these floors sits well below the Standard's 260% line.
Every measurement in the Solomon Standard is built from hospital machine-readable files published under the federal Hospital Price Transparency rule (45 CFR Part 180). These files are published by the hospitals themselves, attested as accurate and complete, and available to anyone.
For inpatient stays, Medicare's payment is calculated per hospital using each facility's own wage-adjusted operating base rate, derived from its CMS Provider of Services file and the applicable wage index. A stay at a rural hospital in North Carolina is compared to what Medicare pays that specific hospital, not a national average. Outpatient services are compared with the 2026 Medicare rate for the same code: the Physician Fee Schedule rate, or Medicare's hospital outpatient (OPPS) payment where that is lower. Clinical laboratory tests and services with no Physician Fee Schedule rate are not included in version 1.
The Standard does not use payer transparency files (Transparency in Coverage), claims data, survey data, or any proprietary data source. Every input is a public record.
A price above 260% of Medicare is not, by itself, a violation of any law. The Standard does not allege fraud, overcharging, or noncompliance. It measures the distance between what a hospital publishes and what Medicare, the largest single payer in the country, pays for the same service.
The Standard does not measure quality of care, patient outcomes, or hospital operating costs. A hospital that prices above the line may deliver excellent care. A hospital that prices below it may not. Price and quality are separate questions. The Standard addresses one of them.
As of October 2026, the Solomon Standard has been applied across ten states. The Solomon Report series intends to measure all fifty.
All published reports are available at solomoncopilot.com/reports.html.
An affordable price already exists in the hospitals' own files. It is reserved for the insurer that negotiated it.