Price Transparency 2023 Recap
As we step into 2024, it marks the third year of public health plan price transparency data being available. Reflecting on the past year, I would like to share some price transparency observations and learnings that we've gathered in 2023.
Catalyzing Strategic Growth
The year 2023 stood out as a pivotal moment for major health systems, including Northwell Health and Prisma Health, in utilizing Payerset's solutions for price transparency. The engagement of these health systems in using this data marks a significant market trend, especially considering that the early adopters of price transparency were primarily health tech, healthcare consulting, and actuarial firms.
We haven't reached widespread democratization of price transparency yet, but there's evident progress in the right direction. Our customers are beginning to realize tangible benefits from the newfound financial clarity they have across markets and their peers.
The data we provide has been instrumental for these organizations, supporting effective negotiations and strategic planning. Our solutions have been critical, whether it's in the context of payer negotiations, managing health systems, or offering consulting services. They have played a key role in fostering revenue growth and informed strategic decision-making.
Significant Progress in Compliance and Data Accuracy
The journey through 2023 was critical for achieving compliance in health plan price transparency. Our rigorous audit of every Machine-Readable File (MRF) from each payer revealed significant advancements:
UnitedHealthcare’s Full Compliance: Achieved in August 2023, UnitedHealthcare addressed earlier discrepancies in their rate structures, providing clarity on actual rates.
Improved Accessibility and Reliability: The year saw a substantial improvement in the accessibility and reliability of large payers’ MRF data. Issues like corrupted or inaccessible files, prevalent early in the year, were effectively resolved.
Expanding Data Sets: A testament to data completeness and continued growth is Aetna’s files, which increased from 5,038 in August to 5,395 by November. This expansion reflects a richer repository of providers, rates, and codes.
The highlight of the year was our ability to accurately link active contracted rates to the penny for major health systems in states like New York, Tennessee, Texas, Kentucky, Utah, and Indiana.
The highlight of the year was our ability to accurately link active contracted rates to the penny for major health systems in states like New York, Tennessee, Texas, Kentucky, Utah, and Indiana. This level of precision challenges the misconception that price transparency data is either unwieldy or inaccurate.
2024: A Year of Practical Application and Expansion
The focus for 2024 is set to shift towards the practical application of this data. We anticipate innovative use cases emerging as early adopters integrate this valuable data into their operational workflows. Moreover, we expect a broader spectrum of organizations to begin leveraging this data, driving their strategic plans.
The road ahead is filled with opportunities, and we at Payerset remain committed to our journey of democratizing price transparency data in healthcare.
We invite you to discover more about our journey and the possibilities at Payerset.com.
Looking forward to an impactful and transformative year!
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