Unlock the power of CMS Price Transparency data to enhance negotiation strategies, and help secure favorable payer contracts.
CMS’s Price Transparency and Transparency in Coverage rules require hospitals and payers to publicly disclose their negotiated rates for all services to increase market competition and drive down the cost of healthcare services. However, due to the lack of standardization, numerous required fields and lack of clarity surrounding these requirements, it is cumbersome to navigate the disparate data and risky to compare negotiated rates for “like” services. This session will dive deep into how transforming the raw, machine-readable file will improve the comparability of negotiated rates and provide a strategy for hospitals and health systems to level the playing field with payers.
Key Learning Objectives:
- Understand the national statistics and recent CMS actions around price transparency, and the pros and cons of using payer machine-readable files.
- Learn how to improve the usability of negotiated rates for ‘apples-to-apples’ comparisons through reclassification of payers and standardization of disparate data.
- Pinpoint areas of opportunity where negotiated rates are lower than those of your peers at the payer, product/plan, patient class and service line level.
- Calculate your negotiated-rate position in the market and gain a competitive advantage to drive increased reimbursement
Meet the Presenters
Natalee Hall
Presenter
Govind Goyal
Presenter
President, Financial Services
Panacea Healthcare Solutions
Kevin Chmura
Moderator
Chief Executive Officer
Panacea Healthcare Solutions