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.
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.
Evidence & Insights From This Project
Related Staff
More like this from Mathematica
See Clearly. Act Quickly.
Our experts can help you make smart, sustainable decisions. From local to global challenges in health, human services, and international development, we’re here to improve public well-being and make progress together.
Work With Us