Revolutionizing Healthcare Negotiations

The Synergy Between Tribunus Health and PayerPrice

In the complex landscape of healthcare negotiations, the synergy between Tribunus Health and PayerPrice has emerged as a game-changer.

The Challenge

1. Data Overload and Complexity: The requirement for payers to comply with price transparency led to a flood of data from insurance companies. This created a new problem: an overwhelming volume of complex, raw data that was difficult to navigate and understand.
2. Lack of Specialized Resources and Expertise: Healthcare providers do not have the resources or training needed to access and interpret this vast amount of data, leaving them at a disadvantage when it comes to understanding their market position and negotiating fair reimbursement rates.
3. Limited Industry Knowledge: Data scientists, on the other hand – lacking experience with managed care contract terms and payment methodologies – struggle to sort and interpret what may appear to be conflicting data. Without national scale and hundreds of reps, the interpretation of the data – even once organized – will not result in high confidence.
4. Insight without Action: Knowledge does not equal power alone. Even if a provider group obtains perfect insight into its relative pay rates, it still needs to create a winning negotiation strategy and carry it out. Done correctly, the time-intensive negotiation will factor in much more than Price Transparency Data.
5. Diversion from Core Healthcare Mission: The demand for providers to and make sense of this complex pricing data threatens to distract them from delivering quality patient care. There’s a critical need to help them deal with the administrative burden so they can focus on health and patient outcomes.

This challenge requires a solution that manages, interprets and translates the data it into actionable insights for providers.

By combining the expertise of the Tribunus Health team in data analysis and negotiations with the network data of PayerPrice, this partnership provides a holistic view of provider competitiveness, for mire effective negotiations.

The marriage of powerful data capabilities with industry-specific expertise has borne critical insights that inform decision making. Pairing that new hard-won knowledge with a negotiation process, the key contacts, and a team of payer contracting experts allows providers to maximize the value of their payer relationships and get paid for the value they provide.

The Solution

Tribunus Health and PayerPrice: A Strategic Alliance

The partnership between Tribunus Health and PayerPrice is built on a foundation of complementary strengths. Tribunus Health brings decades of experience in data analysis and payer negotiations, while PayerPrice offers an extensive database of provider and payer network information. The result is a tool that not only identifies specific rates but also allows users to compare and analyze a wide range of provider rates.

• Iterative Development Process: The development of this tool was driven by a collaborative process that incorporated guidance from the experts on the Tribunus Health team to address their practical needs and insights. Understanding the objectives, methodologies, and user experience requirements was essential in shaping the PayerPrice platform. This user-centric design approach ensured that the tool met real-world negotiation requirements, resulting in a more practical, useful and actionable solution compared to alternatives.

Tribunus Health’s knowledge of the type of presentation that can actually change the course of a payer negotiation was instrumental in shaping our platform to deliver a comprehensive solution that moves beyond fragmented data points to provide a panoramic view of provider competitiveness.”

– Roger Hau, Co-founder, PayerPrice

• Comprehensive Market View: One of the key differentiators of the Tribunus HealthPayerPrice solution is its ability to provide a holistic view of provider competitiveness. Unlike competitors which focus on single data points and are often limited geographically or lack certain key billing codes, this tool offers a panoramic view of the market. Users can identify and compare a range of relevant data points, gaining insights into the overall competitiveness of providers. This broader market context is crucial for effective negotiations, as it enables users to make more informed decisions.
• Identifying Provider Competitiveness: A standout feature of the Tribunus HealthPayerPrice solution is its ability to identify a provider’s competitiveness relative to their peers. This capability is crucial for enabling more effective negotiations, as it provides users with actionable insights. The data is curated and visualized into actionable reports, allowing users to understand the broader market context and strategize accordingly. This comprehensive understanding of provider competitiveness ultimately helps secure better outcomes for clients.

Price Transparency has been a game-changer in terms of the value we can provide clients. Our team’s decades of expertise – their hard-won understanding of what drives payer behavior in negotiations – allows us to glean insight embedded in the data. A more-comprehensive understanding of the market ultimately helps us secure better outcomes for our clients, faster.”

– Kevin Isaacs, President, Tribunus Health

Accurate Data, Expertly Interpreted

The synergistic approach has already made a significant impact in healthcare negotiations.

Our team has successfully used the PayerPrice platform to access accurate data to help us develop strategies and inform negotiations with payers across the country”

– Allison Thomas, VP Accounts, Tribunus Health

The data can reveal where there is market competition and where prices are fairly consistent, making it difficult to negotiate for great reimbursement.

Here is an example of how this innovative tool has changed the game:

Market Entrance:

For a Substance Use Disorder treatment provider seeking to enter the Tennessee market, the Tribunus Health team used the PayerPrice tool to identify the full range of rates in the market and benchmark specific competitors’ rates within the distribution. Our client was then able to adjust their pro forma revenue model based on precise knowledge of achievable in-network rates.

Conclusion

The partnership between Tribunus Health and PayerPrice has revolutionized healthcare negotiations by combining their respective strengths to create a powerful tool. This solution provides a comprehensive market view, identifies provider competitiveness, and offers actionable insights that enable more effective negotiations. The partnership has created a solution that is more valuable than the sum of its parts, transforming the landscape of healthcare negotiations.

The synergy between Tribunus Health and PayerPrice has revolutionized the way healthcare negotiations are conducted. With access to clean, reliable insights from PayerPrice’s platform, Tribunus Health can:

• Quickly identify relevant in-network competitors and leverage their comparative rate information to secure
  the best contracts for their clients.
• Streamline the negotiation process by presenting accurate, up-to-date information to payers.
• Empower providers with data-driven insights.
• By taking that insight directly to payers on behalf of clients, Tribunus helps ensure fair reimbursement rates that pay providers based on the relative value they bring, enabling improved access to high quality care.