Vairate

The last few years have been a whirlwind in the world of price transparency. Our latest article sheds light on: ? Key regulations and events ? Role of innovative companies ? Benefits of price transparency for the different stakeholders ? Current challenges and limitations ? Vision about the impact of price transparency going forward Give it a read! https://lnkd.in/gmuUKe79

#FeatureArticleFriday: In this #SOAHealthWatch article, Greg Mottet delves into inpatient maternity rates using price transparency data, revealing how one payer's negotiation strategy was to negotiate lower rates for shorter stays. This analysis underscores the importance of leveraging transparent pricing to drive cost-effective healthcare solutions. Read more here: https://lnkd.in/gHTXhSgx #HealthCare #PriceTransparency #HealthInsurance

?? A few thoughts on how the new executive order on price transparency affects payer-provider negotiations. Primarily, it's about data quality. We were already seeing a gradual increase in the quality of data published by payers, but this trend will accelerate as the new enforcement guidance kicks in. While the data is already useful in negotiations, there are areas where: - Negotiated terms are murky - Not all codes are reported - Rates aren't trustworthy As we go forward, expect: - Greater accuracy - Fewer gaps & omissions - (Hopefully) less "rate stuffing" - (Hopefully) explanations for multiple rates ?? If you haven't already, now is the time for payers and providers to lean into this data and recognize it as a critical source of competitive intel in negotiations. The data is already highly useful, and the trajectory from here is looking great.

?? Big news in healthcare policy! A new executive order is set to increase the quality and content of price transparency data. Discover how actual price disclosures, standardized data, and strong enforcement will reshape the negotiating environment for both providers and payers. Dive into our latest article to learn more about the impact of these changes. https://lnkd.in/e-TR6ETA

I had a proud moment as a founder last week. I was running a brief demo with a payer when we hit the "Aha" moment. I saw their faces light up and the wheels start turning. "You can see all that from your platform?" We chose a major facility in their service area and had a look at the competition. First, we unpacked the inpatient terms (all MS-DRG based). They were clearly visible, all the way down to the minutia: - One carved out burns, trauma, mental health, and substance abuse. - Two others carved out maternity. - Two negotiated delivery rates aligned with NMHPA minimum stays. - Three had carved out spinal fusions. (Stoploss terms, as usual, were absent.) Then, we looked at the outpatient terms: - We saw the APC conversion factors. - We saw the multiplier for non-RVU based APCs. - We saw the percent of charge terms. (It didn't matter that some payers submitted APCs via CPTs/HCPCS.) One payer had submitted incomplete outpatient data. But for the most part, the contracts where right there in front of us. All of this in a matter of minutes. ____ There's a good chance we can replicate these results for you too. Our platform (DecipherPro) is loaded and ready to go with payer price transparency data from across the country. ?? Click "Book an appointment" above to schedule an intro.

Transparency builds trust. For those of you negotiating payer-provider contracts... How often have you feared your competitors or peers were getting a better deal? It's a common concern I hear among both payers and providers. What's the common denominator? Mistrust. Payers don't trust the providers. (often suspicious their competitors are getting lower rates) Providers don't trust the payers. (often suspicious their peers are getting higher reimbursement) The surprising thing is that post price transparency, I still hear it in conversations on BOTH sides. Given what's possible with the data, I wonder: - How much of the mistrust could be avoided? - How many negotiations could avoid going down to the wire? - How much time could be spent on positive collaboration between payers and providers instead of seeing each other as the enemy? Transparency builds trust. At Vairate, we make negotiations as transparent as possible. Let's move forward together and build trust through transparency. Thoughts? ?? Share them in the comments!

?? These are the key networks we processed this month: (in addition to a few of the smaller ones) United Choice Plus Aetna Open Choice Cigna Open Access Plus Cigna National PPO Cigna LocalPlus BlueCard PPO (by state & entity) ____ Curious about the contracts these entities are negotiating? Check out our flagship product: DecipherPro. Looking to leverage price transparency data in negotiations, but not sure where to start? ?? I'm the person you need to be talking to. Click "Book an appointment" above or send me a message. PS: What networks do you care about that aren't on this list? ?? Let me know in the comments! PPS: If we don't already have it, we can load it.

A large majority of the payer price transparency data is completely useless. The rest? It's the best competitive intel you can get your hands on. You'll hear a lot about data gaps and incomplete submissions. (it's true, there are gaps) But the data is probably richer than you think. You'll hear about inaccuracies. (it's true, I often see data that's obviously wrong) But it's usually not too hard to sift out the garbage. What matters more is whether good data was also submitted. (and this is also often what I see) The key then is really HOW you use this data. It's not like other data sources, though. Most of the time, you can't just filter it, do some actuarial calculations, aggregate it, and call it good. (that's often the fast path to bad intel) So what's the right way to use it? ?? Focus on uncovering reimbursement terms. This is where the gems are. Here's what you do: 1. Identify the Terms: ? Uncover the terms your competitors secured ? Don't stop at just key terms → Find the carveouts too ? Can't find the terms? Consider throwing the data out 2. Validate Accuracy: ? Are the terms reasonable? Complete? ? Now you've got something meaningful 3. Improve Outcomes: ? Align (1) and (2) with your negotiation cycles ? Enter your negotiations armed with the facts ? Negotiate competitive gaps away over time Questions about how to implement something like this? Whether you're searching for an external solution like ours or looking to DIY, I'm here to help. Drop your questions in the comments or message me directly. ——— Find this valuable? ? Repost it to help your network too. ?? Btw, I share posts with healthcare economics and price transparency insights like this one. Follow me (Greg Mottet) so you don't miss the next one.

Welcome to 2025, folks! ?? Here's to a fresh start, another chance to ignore our gym memberships, and more importantly, another year to outsmart the competition. Payers, if you're not using our price transparency app to uncover your competitors' secrets, what are you even doing? ?? Knowing your competitors' terms before negotiations isn’t magic, it's just smart business. And we're here to make it happen. Wishing you all a 2025 filled with smooth negotiations and zero surprises! ??

?? What a year! Reflecting on 2024, it was monumental for Vairate. As we wrap up, here are some highlights: 1. We founded the company 2. Launched our website (vairate.com) 3. Built a pipeline to ingest payer MRFs 4. Launched our flagship product into production: DecipherPro* 5. Went live with our first payer ?? Looking back over the year, I'm grateful for the support of some really incredible people. Special thanks to Ross Laursen, Mark McAllister, Michael Beuoy, Rodger Wenzel, and Jaclyn Trammel who went out of their way to provide feedback and advice. And to Jim Grazko (he/him), an extraordinary healthcare exec and also Vairate's first follower on LinkedIn! And here comes 2025! Wishing you all a truly great year. Here's to the road ahead! ?? * DecipherPro reverse engineers your competitors' price transparency data, so that healthcare economics and network management teams can identify competitive gaps in advance of negotiations. It's a secure and intuitive web application accessed easily through your browser.