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Hospital Price Transparency

Hospital pricing information to ensure proper cost management for member services

While CMS regulations now require hospitals to provide pricing information, the data that hospitals post often fails to come in an accessible, standardized format. The situation isn’t much better for machine-readable full-rate files. Many healthcare systems do not provide CMS-compliant files or only files with partial listings. Even worse, the absence of standardized file types means that data from multiple organizations requires considerable processing for accurate service-to-service comparisons

Hospital Price Transparency gives payers a simple, single-stop resource that gathers hospital pricing information across the US and puts this data into a single resource for actual apples-to-apples pricing comparisons. This secure, cloud-based service removes the burden of data collection, normalization, analytics and presentation, illuminating what it costs to receive care across multiple healthcare organizations and facilities.

Fast, Automated Pricing Comparisons

Hospital Price Transparency collects hospital pricing information from public databases, hospitals and healthcare systems, and other sources. The service collates this information, places it into a standardized format by service code, and supplies the search tools that streamline and simplify price comparison searches across procedure, specialty, geography, payer entity, and a wide variety of other factors. Hospital Price Transparency also supports local, regional, and national research studies on the state of competition between health systems and the effects of pricing transparency on healthcare markets.

Clients use Hospital Price Transparency to know available rates before negotiations, including:

  • Searches by region, DRG, and procedure codes and categories
  • Actual facility-by-facility comparisons
  • Filters for hospitals that do not provide pricing information
  • Easy personalization for specific customer needs

Intuitive analytics deliver immediate insight into:

  • Benchmark prices and rates compared to standard Medicare rates
  • Net pricing differences between insurers within the same hospital or region
  • Average discounts off hospital billed charges

Advanced options analyze this information using client claim volumes for predictions of future hospital payments, the effects of membership changes on pricing, and CMS Star quality reports.

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