Vairate

🚀 Announcing the launch of our website: vairate.com! 🚀 🔓 We're unlocking the power of price transparency in healthcare negotiations. Our platform offers a comprehensive view of competitor contract terms to give you the upper hand. 🔍 Check out our savings calculator to see how improved negotiation outcomes can lead to substantial savings for payers, employers, and members. 💡 Ready to make informed decisions and improve network performance? Visit our website and book a demo to discover how Vairate can help you achieve better outcomes. #Healthcare #PriceTransparency #SaaS #Innovation #Vairate #HealthcareNegotiations

In my very early years I enjoyed growing up in a large wooded area of the northwest--some of the best features being old-growth trees and a giant ravine with a small creek running through it. Every chance we got, my friends and I would make it our day's mission to hold back the water. This would inevitably involve dirt, mud, nettle stings, water pouring over the top of our boots, and sometimes falling all the way in. But when you have a "noble" mission, you give it everything you've got. Healthcare costs are in some ways like that creek. They're always coming, always rising. And if no one is there to push back against the ever rising cost of care, higher costs will continue to prevail. There are many ways health plans have traditionally controlled costs: network management, case management, payment integrity, utilization management, benefit design, etc. Today, there's a new tool payers can use to fight back against the rising tide of healthcare costs. As a result of #pricetransparency, competitors' negotiated terms are now in the public domain. These terms aren't easy to get to, but (for the most part!) they're there. And for health plans that figure out how to extract these at scale, the opportunity to improve network performance by negotiating away competitive disadvantage is substantial. If you're struggling to put all the pieces together to make transparency data a competitive advantage, or if you're just spread too thin and don't have the time to untangle the mess, please message me. I'd be happy to speak with you about your transparency strategy and how we might be able to help.

In my very early years I enjoyed growing up in a large wooded area of the northwest--some of the best features being old-growth trees and a giant ravine with a small creek running through it. Every chance we got, my friends and I would make it our day's mission to hold back the water. This would inevitably involve dirt, mud, nettle stings, water pouring over the top of our boots, and sometimes falling all the way in. But when you have a "noble" mission, you give it everything you've got. Healthcare costs are in some ways like that creek. They're always coming, always rising. And if no one is there to push back against the ever rising cost of care, higher costs will continue to prevail. There are many ways health plans have traditionally controlled costs: network management, case management, payment integrity, utilization management, benefit design, etc. Today, there's a new tool payers can use to fight back against the rising tide of healthcare costs. As a result of #pricetransparency, competitors' negotiated terms are now in the public domain. These terms aren't easy to get to, but (for the most part!) they're there. And for health plans that figure out how to extract these at scale, the opportunity to improve network performance by negotiating away competitive disadvantage is substantial. If you're struggling to put all the pieces together to make transparency data a competitive advantage, or if you're just spread too thin and don't have the time to untangle the mess, please message me. I'd be happy to speak with you about your transparency strategy and how we might be able to help.

❓Why do healthcare costs keep rising above inflation? It's not a simple question, and there isn't a simple answer. But let's explore this by comparing and contrasting a healthy market with US healthcare. ⚖️ 𝐇𝐞𝐚𝐥𝐭𝐡𝐲 𝐔𝐒 𝐌𝐚𝐫𝐤𝐞𝐭 Hundreds of millions of consumers: ✅ Know what they need ✅ Know what it costs ✅ Pay for each good or service ✅ Keep prices in check by making one of three decisions: (1) Yes (2) No (3) Yes to an alternative 💡Turns out options (2) and (3) have extraordinary power to keep prices in check. Need convincing? Look no further than Amazon. 🏥𝐔𝐒 𝐇𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 ❌ Not always clear what you need without the help of a healthcare professional ❌ Price is difficult to know in advance or at the point of care (although this is improving) ❌ Prices are negotiated in aggregate by a small set of people working on behalf of consumers rather than hundreds of millions of consumers working on behalf of themselves. ❌ Majority of healthcare costs are incurred beyond the deductible/coinsurance/copays ❌ When you're really sick, economics go out the window, and the price doesn't matter 💡The result? ➝ "Yes"/"No" decisions don't carry their typical financial disincentive/incentive ➝ "Yes" doesn't turn to "No" as prices rise ➝ "Yes" doesn't turn to "No" as the value of a service decreases ➝ "Yes to an alternative" is severely underutilized 📈 Costs continue to rise This is one angle, but it's not the only one. And there's a lot more to unpack here. What's your take?

In the short history of #pricetransparency, this article from Boston Consulting Group is an "oldie but a goodie." Here are some key takeaways: 1️⃣ "Providers and insurers that want to be prepared have 12 to 18 months to get ready as the new competitive environment takes shape." 💡This was written 19 months ago. ⏰Time's up! 2️⃣ "[D]isruptive regulatory changes often attract new players to the value chain. In this case, the new entrants will likely exploit an ability to aggregate and manage pricing data and potentially marry it with other data..." 💡 Two of the many examples: Serif Health: transparency data and rate insights supplemented with external sources Vairate: transparency in payer-provider negotiations 3️⃣ "Cross-provider and cross-insurer price disparities will likely narrow" 4️⃣ "Negotiations between providers and insurers can be expected to become more fact-based and detailed" 5️⃣ "Insurers will need...databases, maintained in real time, that track how other insurers are reimbursing the providers in their networks." 6️⃣ "[A]rming physicians in the insurer’s network with the information needed to guide patients to the most cost-effective option may be a potentially powerful tool for modifying patient behavior." So how did they do? Spot on? What do you think?

In the short history of #pricetransparency, this article from Boston Consulting Group is an "oldie but a goodie." Here are some key takeaways: 1️⃣ "Providers and insurers that want to be prepared have 12 to 18 months to get ready as the new competitive environment takes shape." 💡This was written 19 months ago. ⏰Time's up! 2️⃣"[D]isruptive regulatory changes often attract new players to the value chain. In this case, the new entrants will likely exploit an ability to aggregate and manage pricing data and potentially marry it with other data..." 💡 Two of the many examples: Serif Health: transparency data and rate insights supplemented with external sources Vairate: transparency in payer-provider negotiations 3️⃣ "Cross-provider and cross-insurer price disparities will likely narrow" 4️⃣ "Negotiations between providers and insurers can be expected to become more fact-based and detailed" 5️⃣"Insurers will need...databases, maintained in real time, that track how other insurers are reimbursing the providers in their networks." 6️⃣"[A]rming physicians in the insurer’s network with the information needed to guide patients to the most cost-effective option may be a potentially powerful tool for modifying patient behavior." So how did they do? Spot on? What do you think? https://lnkd.in/gUxsc8nt

💡My view on how #pricetransparency affects payer negotiations with providers: ➡️ The red lines in negotiation will change: ↳ Increasingly as payers learn how to extract competitors' terms in full and at scale ↳ Payers at a disadvantage will seek to close gaps ↳ Payers with an advantage will look to keep it, but might find they have less ability to negotiate improved rates compared to their disadvantaged competitors ↳ The net result is likely some degree of rate compression among payers ➡️ Increased negotiating leverage for providers with the lowest rates: ↳ Smaller providers with lower rates will be able to know what their larger peers have negotiated ↳ They may still find that their size limits leverage, but leverage will increase nonetheless with knowledge of peer rates ↳ It will take longer for smaller providers with fewer resources to observe this effect as access to peer terms remains difficult ➡️ Decreased negotiating leverage for providers with the highest rates: ↳ The argument for increased reimbursement becomes increasingly difficult as providers approach the highest rates among peers. ↳ As public discontent with healthcare prices grows, providers with unreasonably high prices in relation to their peers may find themselves caught in negative PR. 💬 What are your thoughts? Did I miss anything?