Thanks to recent federal legislation, healthcare data has become more accessible to U.S. employers and patients than ever before. The Hospital Price Transparency rule, established in 2020 and effective in 2021, requires hospitals to disclose service pricing. Further legislation has prohibited gag clauses, mandated prescription drug price sharing, and required that payer and provider-negotiated rates be made available. These measures are intended to support employers involved in health plan management and ultimately lead to more affordable, higher-quality care for employees. However, as Aesop’s fable warns, "too much of a good thing" can be overwhelming. Self-funded employers and their plan participants now face a flood of information, leaving them uncertain about using this new data effectively.
The good news is that many companies, including Health Cost IQ (HCIQ), have stepped up and developed tools that can ingest, process, organize, and make sense of all this data. HCIQ’s MedPrice Insight tool transforms raw payer data to data that can be used, particularly by those in the self-insured ecosystem, to enhance operations, optimize planning, and improve care delivery. In this post, we’ll discuss many of the valuable ways businesses can use this data to unlock significant business value.
With access to vetted, well-organized data housed in a powerful analytic tool, businesses within the self-insured ecosystem can make data-based decisions based on total provider fees and member out-of-pocket costs. Potentially, for the first time, they can compare service costs across physician specialties, facilities, and geographic locations. They can have detailed information on payer reimbursement rates organized by ZIP code, payer network, taxonomy, NPI, or EIN. Furthermore, businesses can gain access to in-network contracts and specific negotiated rates between payers and providers, right down to the individual provider level.
With this level of insight, businesses in the self-insured sector can unlock new opportunities to improve health plan strategies, offer better employee benefits, and reduce healthcare costs. Let’s explore some of the specific ways this intelligence can be utilized.
The ideas above are just a starting point for what’s possible. With access to MPI, self-funded employers and the operations that support them can also perform payment auditing, create insurance plans uniquely suited for a geographic location, and develop solid reference-based pricing programs. The opportunities are vast, and the potential business value is extensive.
MPI offers businesses unparalleled access to trustworthy, vetted data that can transform operations and drive success. As a robust price transparency tool, MPI can provide unique benefits for different stakeholders. Consider the following opportunities:
With MPI’s diverse capabilities, users can tailor its applications to meet their specific needs and objectives.
If MPI sounds like the transformative tool your team needs, I invite you to connect with our experts for a personalized consultation. Contact HCIQ today to discover how MPI can elevate your business strategy and operational efficiency.