Over the past several years, we’ve learned a thing or two about grabbing machine-readable files (MRFs) and making the underlying data accessible to the public. When Transparency in Coverage (TiC) went into effect in July of 2022, non-hospital rates became available for the first time. Payer-negotiated rates for infusion centers, labs, ambulatory surgery centers, behavioral health practices, and more arrived as a complement to the hospital data. We went from seeing half a Monet painting to the whole thing, which is too glorious for us to keep to ourselves!
Payer Data at Your Fingertips
Today we are proud to announce Rate Sense with Payer Data: the easiest and quickest way to access data from TiC MRFs at the click of a button. Oh, and it’s free to try.
Call it what you want: a no-code transparency data platform. A search engine built atop MRFs. The OG Rate Sense getting a glow-up. Monet’s Water Lilies. A lightweight query tool for negotiated rates. ChatGPT for payer-provider contracts*. However you choose to describe it, here’s the TL;DR: price transparency data, both from the original Hospital Final Rule and now TiC, is accessible via the tool you already know and love.
*Our Legal Eagle Dan confirms this is not an acceptable name. Rebranding efforts to ChatCPT begin now.
A Buffet of Features
The search engine is now loaded with over 7.4 billion institutional rates for all major payers and any regional payer that ranks in the top five of covered lives in each state. For the vocab quiz after the blog, covered lives = total number of people (members, subscribers, and dependents) enrolled in a health insurance plan administered by a health insurer. Filter across geographies, code types (think DRGs or CPTs), service lines (think revenue codes or MDCs), payers, and provider types with the same effort it took to click into this post.
Were you hoping for the, “But wait, there’s more!” moment? We’ve arrived. Our smart, good-looking, and funny product team also enriched the data to maximize usefulness.
For example, providers and organizations are identified by name and not numerical identifiers like EINs or NPIs. Insurance networks are clearly labeled to avoid inaccuracies when rates are rolled up at the carrier level.
Pivoting to the Nerdy Stuff
Enjoy data tinkering on evenings and weekends? Honestly, same. Fortunately, the resulting data from searches does not live exclusively within Turquoise. You can export search results for analysis in Excel or the BI tool of your choosing.
If you’re too busy to export data for pivot table nirvana, or you just need an executive summary for a meeting in 10 minutes, our Benchmarks interface summarizes the data for you. View unit price percentiles across the different types of negotiated rates or minimum, maximum and average prices if you’re really in a hurry (also wow, you sound quite busy!).
Data Opacity is So Yesterday
Price transparency data accessibility is top of mind across the industry, and we’re seeing an increase in conversations regarding any hold-ups in getting a working knowledge of the cost of care into the hands of patients as consumers.
Those conversations include a few US Senators and an entire House Committee. As an aside, if you also wondered if Capitol Hill was sitting on an actual hill or if Schoolhouse Rock just said that for a sweet, sweet rhyme, Turquoise CEO Chris Severn confirmed an increase in elevation.
There’s a lot in store for Rate Sense and the rest of our platform in the coming weeks, so keep your ear to the ground for more announcements. Spoiler alert: we’ve begun to infuse TiC payer data into every Turquoise product.
But we’ve done enough talking - why don’t you jump in and give it a spin? Click here to make an account and explore Rate Sense!