INSIGHT #3: AUGUST 2023
Optimize Reimbursement and Pricing Strategies with MRF Data
Our first MRF insight illustrated how our machine-learning methodology reduces data from tens of thousands of BCBS and competitor plans into a manageable list of network products that allows for more meaningful analysis and comparison of individual networks.
In this insight, we show how Transparency Analytics uses this data, enriched with claims utilization data from BHI’s National Data Repository, to deliver more precise weighting and analysis of pricing strategies in a Plan’s local market.
The graphic below compares Blue Plan’s PPO pricing strategy against those of UHC and Cigna in one facility. While total observed costs for the facility show a Blue Plan advantage, the ability to dig deeper into specific service-level and procedure pricing revealed details critical to the Plan’s future price negotiation strategy with this provider.
Get Started
Access to MRF data empowers Plan leaders with comprehensive market intelligence that helps them optimize market positioning and seize competitive opportunities in provider negotiations. Get more information today.
INTENDED FOR BCBS USE ONLY. DO NOT SHARE OR DISTRIBUTE EXTERNALLY.
Insight #4: Using MRF Data to Competitively Price Telehealth Services
The end of the COVID-19 public health emergency means some states will not require payment parity for telehealth.
Insight #2: Use MRF Data to Uncover Blind Spots in Your Network Strategy
Machine-readable files (MRFs) offer Plan leaders the ability to understand real-time market positions – before they begin network negotiations.
Insight #1: From Many to Few: Making MRF Data Usable
Our methodology “flattens” repetitive networks, reduces data by more than 99% to give Plans more accurate Plan comparisons.
Sign Up to Receive MRF Insights
Get the information you need to
stay ahead of the curve.
