Pricing & Payment Intelligence

Fact: Health Plans take advantage of information asymmetries to extract profit from Providers.  

Eliminate this powerful information disadvantage and improve your bottom line. 

• CMS’s Pricing transparency rules changes the equation for providers. 
• We’ve pulled 4 Petabytes of “TIC” files and applied 50,000 compute hours to distill payer rates and built a user-friendly application giving you access to every major plan in every market. 
• Others dump a terabyte of data at you for small market scopes and say good luck.

Fact: Payers have been prevented from knowing competitor rates. 

• CMS’s Pricing transparency rules changes the equation for Payers as well.  
• Price Transparency makes knowing competitor rates an imperative to their success. 

For Providers:

Previously hidden and significant variations in rates prevail across markets, providers and services.

• Level up Negotiations with information parity of your established plan rates versus every Competitor— local, regional or national in any market.
• Help Revenue Cycle resources drive bottom line improvement; preserve fair rates & improve underperforming rates with transparency.
• Augment newfound rate transparency with safety & outcomes metrics, financial, cost of care, margin—for all competitors—to achieve the rates you deserve. 
• Enhance M&A activity, new development, service line optimization, and affiliations to gain strategic advantage. 
• Amplify Network Development efforts—identify high/low-margin and cost providers.
• Provide Boards with accurate assessments of payer risks and opportunities. 
• Communicate with constituents about value for money.

Knowing everyone’s prices, costs, margins and payment rates offers more of what you need to know to prosper in your market.

For Payers:

Previous Antitrust regulations prevented understanding competitor pricing strategies. 

• Rationalize pricing with information parity of your established plan rates versus every Competitor– local, regional or national in any market. 
• Prevent overpaying by preserving fair rates & improving excessive rates with transparency. 
• Reward value in negotiations with Providers with safety & outcomes metrics, financial, cost of care, and margin.