Healthcare Strategic Growth Blog

Data Transparency in Reimbursement Discussions

Posted by Jennifer Keller on May 19, 2020 4:00:47 PM

Level the Playing Field for More Productive Negotiations

By Jennifer Keller

There’s a discussion across healthcare about the need for greater price transparency. The talk is about whether or not patients should know the hard costs of medical procedures and how much they can expect to pay out of pocket for medical services. Armed with this information, they can shop around for care that fits their quality standards as well as their budget. 

At Stratasan, we feel there’s another layer of healthcare price transparency that’s needed—transparency that can level the playing field in provider-payer reimbursement negotiations. Both providers and payers are in need of more data to inform their negotiating position.

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Tags: market reimbursement analyzer, reimbursement, data confidence, transparency, data transparency

The Value of Having Confidence in Your Data

Posted by James Porter, Ancore Health on Apr 28, 2020 4:58:14 PM

Leverage Adjustable Confidence Scoring for Empowered Payer Negotiations

By Hannah Killian and James Porter

In survey research1, a confidence level is applied to express how confident a researcher is in the data obtained from a population sample. A confidence level lets someone know if they can trust the research data to make decisions. 

Similarly, a confidence level (or score), when applied to all-payer claims data (APCD), indicates the trustworthiness of this data for making healthcare decisions. It’s a metric that ensures integrity and can empower a provider to use this data with greater assurance. 

Greater data confidence can be useful when pursuing a number of healthcare planning initiatives. In this post, we’ll discuss specifically how an adjustable confidence-scoring system is valuable when preparing for provider-payer reimbursement negotiations. Equipped with this tool, providers can:

  1. Experience data with certainty, knowing that the cleaning and curation work has already been done 
  2. Apply their intuition, since variability can be adjusted to allow for the application of local knowledge
  3. Approach negotiations empowered by data insights, assured that the data they’re relying upon to make decisions is trustworthy

Let's get started discussing each of these factors in more detail. 

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Tags: data-driven decisions, data qa, market reimbursement analyzer, reimbursement, data confidence

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