fredheadshotwithgreyCompete more effectively with independent labs, imaging centers, and surgery centers on top procedures

For the past decade, Panacea's clients have asked if we can provide current HCPCS/CPT code level charge data showing what their freestanding competitor labs, imaging centers, surgery centers, and other physician specialties are charging in their geographic areas. More recently, some of our hospital clients have been seeing newspaper, radio, and television ads showing how their prices for top procedures compare unfavorably to their freestanding competitors' advertised prices – and the need for such data continues to increase.

Panacea is pleased to announce that it now has available current average charge data for freestanding facilities and medical offices. Panacea can run reports that calculate the weighted average price by HCPCS/CPT code for customized peer groups and break out statistics by facility, medical office, and/or both combined. The reports can be customized to represent freestanding providers within a specified mile radius of the client and broken down by provider type (e.g. outpatient surgery, clinical laboratory, imaging center, physician specialties etc.) and by freestanding provider NPI number and name.

It may not be financially feasible for hospitals to compete with freestanding providers on all tests and procedures due to materially higher overhead, indigent care, and charity care costs hospitals must absorb. However, Panacea believes that competing more effectively on high-volume imaging, lab, therapy, outpatient surgery, and other procedures can be financially feasible by cross-subsidizing the loss in revenue through increases in revenue from other services. This cross-subsidization can be done through negotiations with payors for higher bundled or per diem rates and by identifying other tests and procedures for which the hospital's current prices are below the hospital market average and increasing prices accordingly. This process, of course, requires a service code level review of charge payor utilization, fee schedule reimbursement, and market data. The chart above illustrates how a few top lab, imaging, and outpatient surgery procedures in the state of Illinois compare between short-term hospitals and freestanding providers.

Panacea's Hospital Zero-Base Pricing clients now have the technology and the consulting support to perform vital gross and net revenue modeling in the increasingly competitive world of healthcare pricing with the purchase of the newly offered freestanding data. Panacea also will be offering the data through its current system as a new optional upgrade, and since the system is no longer limited to hospital data, its name will change to soon.

Finally, it is important to note that the data is very current (based on non-Medicare claims data through February 2015), and Panacea plans on refreshing the data every six months at no additional cost to those clients licensing the new module.

If you would like more information on how you can obtain a report or access to the entire national data set, or if you need assistance with establishing more rational, defensible, and competitive charges, please contact John Anderson at This email address is being protected from spambots. You need JavaScript enabled to view it. or register here.