The last few years have been a whirlwind in the world of price transparency. Our latest article sheds light on: • Key regulations and events • Role of innovative companies • Benefits of price transparency for the different stakeholders • Current challenges and limitations • Vision about the impact of price transparency going forward Give it a read! https://lnkd.in/gmuUKe79
Vairate
Software Development
Seattle, Washington 74 followers
Unlocking Transparency in Healthcare Negotiations
About us
⬆️ +Follow ⬆️ Vairate is dedicated to transforming the healthcare industry through transparency. Our tech-enabled solutions provide critical insights into healthcare payments, empowering organizations to navigate complex negotiations with clarity and confidence. 𝗪𝗵𝗮𝘁 𝗪𝗲 𝗗𝗼 Leveraging the power of Transparency in Coverage data, our platform reveals essential insights into payer-provider contracts. With a clear view of competitors' negotiated terms, our clients are among the best equipped to improve network performance and negotiated rates. 𝗔𝗯𝗼𝘂𝘁 𝗨𝘀 Our focus is on making healthcare negotiations as transparent as possible. Our mission is to foster a more transparent, fair, and efficient healthcare system by illuminating healthcare payments and empowering our clients. We are committed to removing the guesswork that often surrounds healthcare negotiations, replacing uncertainty with clear, actionable knowledge. 𝗪𝗵𝘆 𝗖𝗵𝗼𝗼𝘀𝗲 𝗨𝘀 We've been on the frontlines too. With deep industry experience and expertise in technology, we are uniquely positioned to address the challenges of price transparency. Our tools streamline the data acquisition and analysis process, allowing healthcare executives to focus more on outcomes and less on overcoming informational barriers. 𝗟𝗼𝗼𝗸𝗶𝗻𝗴 𝗔𝗵𝗲𝗮𝗱 While our current solutions are tailored primarily for payers, we are excited about our roadmap which includes expanding our offerings to providers and other healthcare entities. Stay tuned for innovative features that will continue to revolutionize how healthcare negotiations are conducted. 𝗚𝗲𝘁 𝗜𝗻𝘃𝗼𝗹𝘃𝗲𝗱 Follow our LinkedIn page for the latest updates and insights. Join us in shaping a more transparent future for healthcare. 🌐 vairate.com ⬆️ +Follow ⬆️
- Website
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https://www.vairate.com
External link for Vairate
- Industry
- Software Development
- Company size
- 2-10 employees
- Headquarters
- Seattle, Washington
- Type
- Privately Held
- Specialties
- Price Transparency, Healthcare Economics, Network Optimization, Negotiation Support, Software Development, and Web Applications
Locations
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Primary
600 1st Ave
Seattle, Washington 98104, US
Updates
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Transparency data isn’t just a compliance box to tick. When approached correctly, it offers a wealth of insight that can enhance your organization’s efficiency and competitive standing. For a mid-sized health plan processing allowed claims of $10 billion, every 1% improvement in network unit cost efficiency translates to $100 million in savings spread across members, employers, and the health plan. The benefits are clear: • Lower out-of-pocket • Lower premiums • Increased customer satisfaction • Increased membership • Better spread of fixed costs • More profit How is your organization using transparency data to stay ahead? #HealthcareStrategy #DataDrivenDecisions #HealthcareEconomics
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Vairate reposted this
Founder @ Vairate | Simplifying Price Transparency | Enabling Smarter Negotiations with Competitor Insights | Informative Content Weekly 📰
💡Reflecting on an insightful American Academy of Actuaries brief from 2022, we saw the potential of price transparency to reshape provider contract negotiations. Fast forward to 2024, and improved rates on high-cost outlier contracts and reductions in unit cost are still on the table. 🤔 By leveraging price transparency data, payers can redefine negotiations, especially in competitive markets. But putting all the pieces together is challenging without the right support. ❓Do you know the contracts where your organization is a high-cost outlier? And do you know your competitors' terms? #Healthcare #PriceTransparency #Innovation
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Health plans today face a vital moment: the details that determine provider payment are now public, introducing a new level of competition. The challenge? Navigating and leveraging this data effectively. By mastering competitor transparency data, your organization can transform a regulatory requirement into a strategic advantage. The key lies in using this data to improve network performance, unit cost efficiency, and your competitive standing. Are you ready to turn transparency into your competitive edge? #HealthPlans #DataStrategy #HealthcareInnovation #CompetitiveAdvantage
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Vairate reposted this
Founder @ Vairate | Simplifying Price Transparency | Enabling Smarter Negotiations with Competitor Insights | Informative Content Weekly 📰
Maternity is one of the most common carveouts in inpatient contracts. But the success payers have in negotiating favorable rates varies widely. This plot shows distributions of delivery MS-DRG rates across payers. These are the specs: • BUCA only • Hospitals only • Washington state • All delivery MS-DRGs (normal & cesarean) We see that Payer 4 was far more successful in negotiating favorable maternity rates. Stay tuned for the full study showing how they did it. In the meantime, care to take a guess? 💬 Leave your thoughts below. 👏 Bonus points for guesses. 🏆 Kudos if you can nail it!
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Founder @ Vairate | Simplifying Price Transparency | Enabling Smarter Negotiations with Competitor Insights | Informative Content Weekly 📰
Here's how to leverage price transparency data in support of contract negotiations, along with a common pitfall. Let's take a closer look. The data comes from a BUCAH MRF, filtered down to a single EIN and codes 99203-99205 (new patient visits). Notice anything? Here's what I see: • They submitted 420 records with only 12 unique rates • They submitted 4 unique rates for every code • The 4 rates follow a pattern Here's what they represent from lowest to highest: 1️⃣ Facility POS w/ 5% mid-level provider discount 2️⃣ Facility POS 3️⃣ Non-Facility POS w/ 5% mid-level provider discount 4️⃣ Non-Facility POS Looking across all codes, we can see the underlying contract is: • $80.79 2021 National RBRVS • Adjusted for site of service • 5% mid-level provider discount Understanding how the data was generated is critical. In this case, we can see there's a clear underlying contract, which gives us confidence that we've arrived at the right answer. What if we had aggregated the data instead? (e.g. mean, mode, min, max, etc.) Each of these statistics would have led to an incorrect conclusion! The takeaway? Aggregation is easy, but will almost always be misleading. It's worth it to do the work to find the underlying terms.
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Founder @ Vairate | Simplifying Price Transparency | Enabling Smarter Negotiations with Competitor Insights | Informative Content Weekly 📰
📊 Here's a surprising price transparency stat you may have missed. The recent PwC medical trend survey asked respondents about the impact of price transparency on medical trend. 𝗢𝗻𝗹𝘆 𝟱% 𝗼𝗳 𝘁𝗵𝗲 𝗵𝗲𝗮𝗹𝘁𝗵 𝗽𝗹𝗮𝗻𝘀 𝘀𝘂𝗿𝘃𝗲𝘆𝗲𝗱 𝗲𝘅𝗽𝗲𝗰𝘁 𝗽𝗿𝗶𝗰𝗲 𝘁𝗿𝗮𝗻𝘀𝗽𝗮𝗿𝗲𝗻𝗰𝘆 𝘁𝗼 𝗵𝗮𝘃𝗲 𝗮 𝗺𝗮𝘁𝗲𝗿𝗶𝗮𝗹 𝗲𝗳𝗳𝗲𝗰𝘁 𝗼𝗻 𝗺𝗲𝗱𝗶𝗰𝗮𝗹 𝘁𝗿𝗲𝗻𝗱 𝗻𝗲𝘅𝘁 𝘆𝗲𝗮𝗿. Down from 25% last year. Why the drop? The study indicated some "early signs of successful application" along with "several hurdles" such as "data accuracy and completeness". I often find shortcomings in the data, such as: • Missing codes • Missing stoploss terms • Erroneous or unnecessary records 𝗕𝘂𝘁 𝗯𝗮𝘀𝗲𝗱 𝗼𝗻 𝘄𝗵𝗮𝘁 𝘄𝗲'𝗿𝗲 𝘀𝗲𝗲𝗶𝗻𝗴 𝗮𝘁 Vairate, 𝘄𝗲 𝗯𝗲𝗹𝗶𝗲𝘃𝗲 𝗽𝗮𝘆𝗲𝗿𝘀 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗵𝗮𝘃𝗶𝗻𝗴 𝗳𝗮𝗿 𝗺𝗼𝗿𝗲 𝘀𝘂𝗰𝗰𝗲𝘀𝘀 𝘁𝗵𝗮𝗻 𝗿𝗲𝗽𝗼𝗿𝘁𝗲𝗱. 💡 My view is that the problem has less to do with the data and more to do with the unique combination of technology, process, and domain expertise required to separate the gold from the dross. ( 🔗 link to the study in the comments) What are your thoughts?
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Founder @ Vairate | Simplifying Price Transparency | Enabling Smarter Negotiations with Competitor Insights | Informative Content Weekly 📰
📝 Key takeaways from the 2025 PwC medical cost trend study. (1) Group market trends rising from 7.5% in 2024 to 8.0% in 2025 (2) Individual market trends rising from 7.0% in 2024 to 7.5% in 2025 (3) Upward revision of 2023: 6.0% (overall) to 6.5% (individual) / 8.0% (group) Note: trends include unit cost, utilization, and service intensity. It's an excellent study loaded with insight, and I encourage you to read it in full. TL;DR 📈 Key inflators - Higher negotiated rates: driven by hospital-related services - Prescription drugs: new treatments and therapies - Behavioral health: utilization & limited supply leading to higher unit cost 📉 Key deflators - Biosimilars: estimated savings rising to $38.8B in 2025 - Total cost of care management: shift toward holistic cost of care teams 🔍 Trends to watch - CMS price transparency - Generative AI - Medicaid redetermination - No Surprises Act - Inflation Reduction Act (🔗 link to the study in the comments) Anything else you would add? What else are you seeing?
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🚀 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
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Vairate reposted this
Founder @ Vairate | Simplifying Price Transparency | Enabling Smarter Negotiations with Competitor Insights | Informative Content Weekly 📰
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.
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