Healthcare Price Transparency

Finally, hospitals and health systems can now benefit from actionable commercial pricing transparency.

The US Healthcare System is known for having the most intricate economic structure compared to any other healthcare system worldwide. As it operates within a unique blend of public and private financing models, different reimbursement structures, and variable costs influenced by negotiated rates with payers, discounted cash prices, and other charges, establishing commercial standardized pricing has been challenging.

As for comparing commercial pricing between competing health systems or negotiated rates between different payers, the lack of standardized benchmarking and transparency measures has made it impossible to assess and act upon true cost differentials. Historically, commercial pricing is considered to be an industry trade secret. This has effectively prevented informed competition, meaningful price negotiations, and system-wide cost containment.

However, with the help of reliable pricing information made available by The Hospital Price Transparency Rule, the Transparency in Coverage Rule, and the No Surprises Act, health systems and other supporting legislation, we can finally benchmark publicly posted data from providers, facilities, and payers and gain insight into the actual unit of cost for medical procedures, services, and procedures, within and across the healthcare delivery ecosystem.

With NFP’s proprietary tool TPCompare^TM, a first-of-its-kind business intelligence tool designed to analyze transparency data with support from quality metrics, claims payments, cash pay data, and CMS, Medicare/Medicaid rates, hospitals can now examine procedure and service pricing variations across all facilities and practitioners, regardless of location or system.

TPCompare^TM helps aggregate and normalize the data with actionable reporting. Ingesting and analyzing the comprehensive data sets into a single source reveals a holistic picture of the entire commercial healthcare system.

With NFP as your partner and TPCompare^TM as your guide, we can provide your health system with strategic advantages over your competitors. By comparing negotiated pricing structures across the competitive landscape, hospitals can effectively negotiate contract pricing with payers, reduce expenses through system aggregation, improve market share, and build new revenue streams.