Price Transparency Data Use Cases

Price transparency data has many applications across healthcare. Below is a non-exhaustive list of common use cases for price transparency data broken down by industry.

Health System Uses Cases

• Rate analysis for planned contract renewals and renegotiations
• CDM optimization
• Site-of-service rate comparisons
• Competitive analysis of other hospitals or health systems
• Evaluate potential joint ventures
• Financial modeling for new service lines
• Rates used as the basis for patient estimate tools, GFEs, or AEOBs

Payer Use Cases

• Rate analysis for planned contract renewals and renegotiations
• Strategy/analytics/network contracting
• Site-of-service rate comparisons
• Competitive analysis of other payers
• Rates used as the basis for patient estimate tools or AEOBs

Speciality Provider Use Cases

• Rate analysis for planned contract renewals and renegotiations
• Site-of-service rate comparisons
• Competitive analysis of providers within the same specialty
• Competitive analysis of hospitals or health systems that have a department for the same specialty
• Evaluate potential joint ventures
• Financial modeling for new service lines
• Rates used as the basis for patient estimate tools, GFEs, or AEOBs

Life Sciences Use Cases

• Reimbursement modeling and scenario planning
• Education materials as part of a budget analysis tool
• Rates used as the basis for patient estimate tools