Negotiating Better Rates: Strategies for Using Transparency Data Effectively
Securing better healthcare rates demands a strategic approach. Here’s how Health Fund Administrators can turn the tide in their favor using transparency data. Here is how:
- Negotiate better rates with your network: Utilize the transparency tool to gather data on service costs across different providers. Identifying cost variances can give you the information needed to negotiate better rates for procedures, services, supplies and medications.
As an example, a quick cost variance report can be pulled for identical procedure codes for different providers in the same zip code as shown in the table below. Armed with this insight an administrator is able to confidently come to negotiation table when renewing
| Description | Code | Low Price | High Price | Variance |
| MRI scan of abdomen with contrast | 74182 | $193 | $4,122 | 2136% |
| Removal of large bowel tissue using a flexible endoscope | 45390 | $189 | $6,814 | 3605% |
| Test for detection of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody, qualitative or semiquantitative | 86328 | $18 | $250 | 1389% |
| Test for detecting genes associated with heart disease, duplication/deletion analysis panel | 81411 | $473 | $6,438 | 1361% |
| Liver transplant with mcc or intestinal transplant | 005 | $5,217 | $219,337 | 4204% |
| Removal of tonsils (12 years or older) | 42826 | $144 | $12,788 | 8881% |
- Compare costs between similar providers: Transparency data provides insight into what different providers charge for similar services, helping you understand the market rate and identify opportunities for savings.
- Optimize Network Design: Analyze the cost and quality data to optimize your network, focusing on providers that offer the best value. This can also be a negotiation point when adding providers and benefits to your network.
- Forge Strategic Alliances: Transparency data can reveal providers that align with your goals. Target these for partnerships that promise mutual benefits and long-term savings.
How Viveka Health Enhances Your Strategy:
The Viveka Health administration platform offers the tools you need to transform transparency data into actionable insights. Its analytics capabilities allow you to dissect cost and quality metrics, equipping you with the knowledge to identify the best negotiation opportunities and craft compelling arguments for better rates. With Viveka Health, navigating the complexities of provider negotiations becomes a data-driven, strategic process aimed at achieving the best outcomes for your members.