From Data to Decisions: Payerset's Path in Demystifying Price Transparency

demystifying price transparency

Hello All,

There is a plethora of use cases for price transparency data, and we are merely at the beginning of discovering them all. The diverse perspectives people have when examining this data truly excites me, showcasing a landscape rich with possibilities. The process begins with Step 1: the creation of technology capable of processing and storing all this data swiftly and affordably. Step 2 follows: maintaining a historical record of the industries' prices. We at Payerset have proudly achieved both steps, and now the stage is set to make a substantial impact and demystify price transparency.

Here’s a glimpse of the feedback and insights we’ve gathered from our customers and industry conversations regarding the potential benefits of this data.

This finesse of balancing potential savings of millions with adjustments in high volume or high-cost services, without becoming a target for payers, is akin to an expert ship captain steering a massive vessel with precision.

Hospital Systems - There’s immense potential here to effect change rapidly, although the adoption rate might lag. When discussing rate variations, it's critical to also address the varying capabilities of financial leaders within health systems. We’ve encountered contracting teams well-versed in leveraging this data, adept at holding firm on their rates while making strategic adjustments during payer negotiations. This finesse of balancing potential savings of millions with adjustments in high volume or high-cost services, without becoming a target for payers, is akin to an expert ship captain steering a massive vessel with precision. Conversely, some financial leaders find themselves overwhelmed, akin to a deer caught in headlights, unsure of how to utilize this data. The trailblazers and change agents in this sphere will undoubtedly lay down the path for others to follow, although I ardently wish the pace of this transformation could be accelerated. The prevailing attitudes of fear, risk-aversion, and adherence to the status quo are significant roadblocks to addressing healthcare costs.

Benefits Navigation Companies - These orgs view the data through a distinct lens, developing workflows and automation to enhance provider recommendations and streamline the care journey for their members. With a solid grasp of their member's reporting plans, they aim to navigate rates based on the specific services needed, considering factors like location. This approach starkly contrasts with the rate benchmarking seen in hospital systems.

It’s worth noting that major payers have had access to this data or proxy data, which has been their competitive edge for years.

Payers - They are keen on leveraging this data to proactively engage in discussions with provider organizations and to gain a competitive advantage in RFP scenarios. It’s worth noting that major payers have had access to this data or proxy data, which has been their competitive edge for years.

Specialty Clinics - Much like Health Systems, they employ this data to negotiate better rates. Additionally, they explore this data for market expansion, presenting an intriguing use case.

The insights from these use cases are continually refining our products and services. We are extremely grateful and excited to be on this journey with our customers. Your partnership is invaluable to us. Our mission is to democratize this data, making it accessible to those who can drive positive change with it.

Payerset is price transparency, simplified.