Get the answers you need with decision-ready data points and the expertise to guide a strategy that increases value.
Newly available pricing data disclosed by health plans is a welcome step in the direction of transparent and accessible care. Yet these data sets are massive and disorganized, and most organizations don't have the resources to download, clean, and analyze them. Leveraging this pricing data offers a competitive advantage now, but it will soon become a business imperative to do so.
Our health care data experts help payers and providers harness this data to develop strategies around rate negotiations, service line growth, and value-based care payment opportunities. Our health care price transparency solution builds on a cloud database that combines cutting-edge data science technology with in-depth industry experience to provide our clients with on-demand access to high-quality price data from all national health plans and regional plans covering commercial plans relevant to their markets. We complement reimbursement data with Medicare rates, provider volumes, and performance on quality-of-care measures to provide insights into the value of care.
To get the specific answers your organization needs, we offer custom professional services engagements as well as access to our price transparency database and a customizable dashboard. Our experts apply extensive experience in healthcare markets, federal and state policies, and payer-provider negotiations to address your unique questions and challenges.
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Find out how we can provide a data-backed framework for decision-making and negotiations.
Connect with an ExpertWith our price transparency database and customizable dashboard, you can:
Access reimbursement data from all national plans and many regional plans covering more than 60% of the commercial health insurance market.
Upload new plan files for on-demand ingestion paired with regular refresh of existing plan data.
Benchmark to provider-specific Medicare rates for comparative analyses.
Link data to Mathematica's other data assets if desired, including 100% access to Medicare and Medicaid claims.
Analyze the value of care using reimbursement rates integrated with data on service volume, utilization, and provider performance.
Get insights in real time with customizable, easy-to-understand visualizations of prices and quality of care specific to your market.
Get quality and validity reports of cleaned and deduplicated data.
Competitive Insights
| For Providers | For Purchasers |
|---|---|
| Access accurate and complete reimbursement data to inform data-driven negotiation with payers. | Gain crucial insights into your plan’s reimbursement rates at the aggregate level as well as service level. |
| Integrate reimbursement rates with data quality performance to differentiate the value of care. | Empower plan members to choose higher-value providers based on both cost and quality. |
| Analyze market trends for reimbursement rates down to the single service level. | Bring together service utilization with reimbursement rates to assess total cost of care. |
| Identify cost saving or growth opportunities for specific service lines. | Reduce price variation across providers. |
| Compare performance with internal and national benchmarks. | Proactively evaluate employer-sponsored health plans to enhance benefit design |
Dashboard At a Glance
EVIDENCE & INSIGHTS
News
Main Line Health Uses Mathematica’s Price Transparency Dashboard to Inform Strategic Decision Making
Mathematica is providing a software-as-a-service solution to help non-profit health system Main Line Health use new plan price transparency data to drive strategies around managed care contracts.
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