Healthy Competition: Leverage Price Transparency for Peer Benchmarking

by 
Kevin Dutton
Company Updates
May 30, 2024

Phrases like 'we're all in this together,' 'healthy competition,' and 'leveling the playing field' are sports analogies that translate well to the business world. Historically, many of these dynamics did not exist in healthcare with the lack of price transparency. However, as healthcare price transparency data has become available, Serif Health is making these phrases a reality for healthcare organizations and providers. In fact, the story of 'Moneyball' and the Oakland A's provides a fitting parallel for how healthcare providers can leverage price transparency data to gain insights on their peers and improve pricing strategy:

The cash-strapped Oakland A's, under GM Billy Beane, gained a competitive edge in the early 2000s by embracing sabermetrics - an analytical approach to evaluating players based on data and empirical stats rather than traditional scouting. By targeting undervalued assets identified through sabermetrics, they were able to compete with big-market teams despite financial constraints, as depicted in Moneyball.

Would you like to emulate Billy Beane and use price transparency data to gain an edge and a better understanding of your market dynamics? Our latest report in Signal can help!

Peer Benchmarks in Signal

We're thrilled to introduce Signal's new Peer Benchmark Report, a powerful tool that enables you to easily compare contracted rates across a customized set of provider organizations. With just a few clicks, you can select your desired peer group and view an intuitive grid breaking down rates by provider, CPT code, and payer - giving you visibility into how your reimbursements stack up against the competition.

  • Gain a comprehensive view of your peers' contracted rates across all their in-network services, locations, and billing codes.
  • Conduct detailed side-by-side comparisons against peer organizations to pinpoint codes and payers where your rates may be lagging.
  • Stay alert to pivotal market shifts, including providers added to new networks, contract renewals with revised terms, and emerging rate disparities 

Each month we update the data so you can track provider’s contracts as they evolve.

Leveraging this transparent rate intelligence empowers you to pinpoint advantageous contract terms and proactively renegotiate to ensure your reimbursements remain competitive in the market.

Peer Benchmarks works in tandem with other modes in Signal (Rate Search and Market Benchmarks) to give you a comprehensive view of the market data.

Peer Benchmarks Breakdown

Let’s analyze a sample report.  Below is a screenshot of a recent Peer Benchmarks report we ran to compare against two hypothetical behavioral health organizations. In a matter of seconds, Signal scanned Serif Health's entire data set and returned: 

  • A complete list of all coded procedures billed by each organization
  • All contracted payer networks for each provider
  • The number of payers found for a given code and EIN combination

As you scan the results a heat map indicates where there are higher concentrations of rates and payer for a given code and EIN.

Selecting a code will expand and display all rates found per unique NPI and taxonomy combinations broken down by payer. Alongside the rate we display the percentage of CMS (if available). 

Selecting the ‘Attributes’ button will display the properties from the MRF file that distinguish the rate.

If you would like a more precise view, you can optionally select payers, codes or taxonomies from the other panel to filter down your results. 

As with the other modes in Signal, you can save the report to easily revisit again and again.

Request Access

Peer Benchmarks is in beta for the next couple of weeks. If you are interested in developing a 'Moneyball' strategy with transparency data to "punch above your weight class", reach out directly at sales@serifhealth.com or book time here.