How CompleteVue™ Can Help
For years, rural healthcare providers have dealt with significant financial challenges. One promising path to sustainability is utilizing the market insights that reside in price transparency data. In this post, we’ll explore how greater visibility into publicly available pricing data can help rural hospitals and health systems accelerate development of financial strategies.
Revenue Capture is Top of Mind for Rural Healthcare Leaders
In a recent survey of rural healthcare organizations, respondents indicated that one of their highest priorities is improving revenue capture.1 To improve revenues, approximately half of the survey participants said they want to renegotiate their payor contracts or change their payor mix. Around two-thirds said they plan to utilize publicly available claims data to develop strategies to increase market share.
Price transparency data can help with many of these initiatives, shedding light on benchmarks related to market share, highly utilized services, and more. “Slicing and dicing” industry pricing data in-house to identify these insights, however, can be complex.
Unlocking Insights in Publicly Available Price Transparency Data Requires Time and Resources
To obtain actionable insights from publicly available price transparency data, rural healthcare providers need teams skilled at analyzing and interpreting the large volumes of information that reside in machine-readable files (MRFs).
Allocating the funds to store this data, then finding data specialists and having budget to hire the talent to use the data can be particularly difficult for rural healthcare organizations with low or even negative financial margins. The work required to parse publicly available price transparency data and isolate key findings has multiple complexities:
- The amount of information is enormous. Publicly available price transparency data covers millions of providers and tens of thousands of procedures. To support trending and comparisons, historical records are also needed. This compounds the volume of data needed for analysis.
- File structures and information sources aren’t static. File repository structures and URLs to access files often change. This makes it challenging and time consuming to retrieve pricing rate files and isolate the relevant information.
- Accurate data interpretation is labor intensive. Published pricing data contains significant variations. In addition, critical information is frequently located in unexpected files or tables. The naming conventions used in the data can also be unclear or misleading.
- A variety of skills are needed to generate actionable insights. This includes broad industry expertise, experience with data science and actuarial analysis, access to efficient indexing and search capabilities, and more.
For many rural healthcare organizations, access to the necessary data science expertise is a significant barrier to leveraging price transparency information for strategic insights. To level the playing field, rural hospitals and health systems need faster and more cost-effective ways to derive value from publicly available price transparency data.
CompleteVue Accelerates the Path to Strategic Financial Action
CompleteVue is a modern data platform powered by Claritev’s industry-leading data science expertise and innovative technology. With easy access to publicly available price transparency data, rural healthcare organizations can improve pricing strategies based on highly utilized services or specific conditions. CompleteVue also supports publicly available rate comparisons across payors and geographies.
CompleteVue provides access to more than 500 billion publicly available MRF records from over 150 payors, uncovering the actionable insights that providers need to create robust pricing strategies. Within seconds, rural hospitals and health systems gain access to information that enables them to:
- Enhance payor negotiations. Key insights derived from public price transparency data help rural healthcare organizations negotiate more effectively with payors. Easy to use comparisons and trend visualizations allow users to compare publicly available pricing data by specific codes, providers, payors, and geographies. In-depth comparison reviews are a key tool that strengthens a provider’s negotiating position.
- Plan for the future. Utilization trends and other benchmarks help rural hospitals and health systems identify promising areas of expansion and growth opportunities. CompleteVue’s Revenue Impact Simulator allows users to interpret the business impact of different utilization and pricing scenarios. This leads to more effective strategic planning and shorter routes to improved financial outcomes.
- Identify key talent gaps. Based on promising market expansion opportunities, rural healthcare organizations can strategically identify and target practitioners for recruitment in high priority areas.
CompleteVue gives rural hospitals and health systems across the country access to publicly available price transparency data, enabling them to bolster their financial viability through a clearer picture of the market landscape. With stronger strategic and financial plans, rural healthcare providers can continue to deliver on their missions: providing high quality care to patients in their communities.
All data within CompleteVue is based on publicly available price transparency machine readable files, Medicare rates, and third-party benchmark data.
1 Gliadkovskaya, A. (2024, February 5). Rural providers optimistic about financial stability, plan to expand services, Wipfli survey finds. Fierce Healthcare. https://www.fiercehealthcare.com/providers/rural-providers-optimistic-amid-financial-challenges-wipfli-survey-finds
