Projects

Main Line Health Uses Mathematica’s Price Transparency Solution to Drive Strategic Decision Making

2023

Project Overview

Objective

To enable Main Line Health to assess relative prices for services across hospitals and health plans in its surrounding markets. Insights from these data will help Main Line Health prepare for payor negotiations with greater efficiency and develop data-driven strategies for service-line growth.

Project Motivation

Contract negotiations between hospitals and insurance plans are cumbersome and opaque because hospitals have minimal insight into how much their competitors are reimbursed for the same services. The lack of price transparency contributes to the wide variation in health care prices, which ultimately hurts consumers.

Partners in Progress

Amazon Web Services

Prepared For

Main Line Health

Mathematica’s Health Care Price Transparency Solution is empowering Main Line Health with the timely data necessary to bring clarity into rate negotiation, improve service-line growth, and identify value-based care payment opportunities.
Main Line Health is a not-for-profit health system serving Philadelphia and its suburbs. The Health Care Price Transparency Solution is transforming how Main Line Health negotiates with health insurers by providing insight into reimbursement rates for hospital inpatient and outpatient services in Main Line Health’s surrounding market. The solution collects, cleans, and organizes health plan data scattered in thousands of machine-readable files across payor websites. The solution’s business intelligence (BI) platform enables Main Line Health to customize queries and create unique analyses for specific market intelligence questions. 

The solution has had a significant impact on Main Line Health’s preparation for the annual payor negotiation cycle. Main Line Health  reports that the tool reduced the time spent preparing for negotiations from three months to several days.
Project Impact

Insights from this data will strengthen our strategies around rate negotiations and identify value-based care payment opportunities.

- Dana Rainey, Associate Vice President of Payor Strategies at Main Line Health

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Evelyn Li

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Rahul Kumar

Rahul Kumar

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