Mathematica’s partners will showcase two digital innovations at the Employers’ Forum of Indiana National Hospital Price Transparency Conference, May 5, 2022, in Indianapolis. For most Americans, hospital costs are a frustrating black box, and the translation from price to value is even harder to understand. Mathematica served as the technology developer for two online tools, Sage Transparency, created in partnership with the Employers’ Forum of Indiana, and the Hospital Cost Tool (HCT), designed in partnership with the National Academy for State Health Policy (NASHP).
Increasing hospital prices are the biggest driver of rising health care spending for Americans with employer-sponsored insurance, as there is minimal price and quality transparency to permit employers and Americans to shop for high value care.
Gloria Sachdev, president and chief executive officer of the Employers’ Forum of Indiana said, “At this year’s conference, we are thrilled to unveil Sage Transparency, an innovative, customizable, web-based hospital price and quality transparency tool, for which we selected Mathematica to be our technology developer. Sage Transparency may be used by consumers, employers, researchers and policy makers. It is free-to-use and leverages data from the RAND 4.0 Hospital Price Transparency Study, Centers for Medicare & Medicaid Services, and other health databases to show the real prices that employers pay for healthcare across the country. We’re hopeful Sage Transparency informs those engaged in employee health benefits, health plan design, provider payment, and those with an interest in health policy to align payment with the value of services provided.”
Sage Transparency, launched on May 5th, is an innovative solution available to the public to help pull back the curtain on hospital pricing. The solution streamlines and presents the different data sets into one dashboard to create a comprehensive view so users can clearly compare hospital quality and price.
“The work of our Sage Transparency team is unique. We are noticing a deep market need for solutions that enable groups to understand hospital prices and quality. Our health care value suite of tools enables diverse groups to gain action-oriented insights into price and quality metrics that are transparent and robust,” said Andrew Hurwitz, senior director of commercial health care and life sciences at Mathematica.
Similarly, the HCT, a new dashboard designed in partnership with NASHP and Mathematica, helps bridge the information gaps on costs and pricing. The dashboard provides state regulators, employers, providers, and researchers with rich data points and intuitive visualizations to analyze hospital costs. It reports on key metrics, such as hospital revenue, net income, profit margins, cost-to-charge ratio, payer mixes, break-even point (when a hospital’s revenue covers costs with zero profit or loss), and prices paid to hospitals by commercial payers from the RAND 3.0 Hospital Price Transparency Study.
“For state health agencies needing to contain health cost growth, the HCT can be a useful tool to start the conversation,” said Bailey Orshan, Mathematica senior researcher and state health area director. “For example, states can use HCT to assess hospital costs and payer-mix, thereby negotiating rates that balance cost-saving and hospital financial viability. States interested in fixed-prospective budget models can also use HCT to inform hospital global budget parameters with Medicaid and commercial payers.”
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