Driving Negotiation Accuracy with Real-Time Market Data
Client: Universal Health Services (UHS) Solution Powered By: Trek Health Challenge: As UHS prepared to launch a new behavioral health service line, their strategy team faced a critical question: were payer reimbursement rates in the target market strong enough to support the expansion? Without precise benchmarking data, negotiating competitive contracts would be guesswork—putting profitability at […]
Using Market Expansion Intelligence to Launch Behavioral Health Services
Client: Universal Health Services (UHS) Solution Powered By: Trek Health Challenge: UHS was preparing to expand its behavioral health offerings into a new state but needed to ensure the market could support the investment. Without a clear view of local reimbursement dynamics, there was a risk of overbuilding, underperforming contracts, and financial inefficiency. Solution: UHS […]
Navigating the 2025 CMS Price Transparency Updates: What Health Systems Need to Know
Navigating the 2025 CMS Price Transparency Updates: What Health Systems Need to Know On May 22, 2025, the Centers for Medicare & Medicaid Services (CMS), alongside the Departments of Labor, Health and Human Services (HHS), and the Treasury, rolled out significant updates to advance the Trump administration’s directive to ensure Americans have clear, accurate, and […]
Healthcare Transparency Laws: Stay Compliant with Trek Health
Navigate Regulations with Confidence Healthcare transparency laws, including the Transparency in Coverage Rule, Hospital Price Transparency Rule, and No Surprises Act, are reshaping provider operations. Trek Health’s platform ensures compliance and leverages these regulations for strategic gains. KFF underscores transparency’s role in cost accountability, while NCSL tracks evolving state laws. Key Federal Transparency Laws 1. Health Plan Pricing Transparency […]
Hospital Price Transparency: Achieve Compliance and Compete
Turn CMS Mandates into Strategic Wins with Trek Health The CMS Hospital Price Transparency Rule requires hospitals to publish pricing data, including gross charges, discounted cash prices, and payer-specific negotiated rates. Compliance is critical to avoid fines, but Trek Health’s tools help you use pricing data to attract patients and outpace competitors. Health Affairs highlights transparency’s role in reshaping […]
Payer Transparency: Maximize Reimbursement with Trek Health
Harness CMS Data for Stronger Payer Contracts The CMS Transparency in Coverage Rule mandates that payers disclose negotiated rates and out-of-network payments, providing a wealth of data for healthcare providers. Trek Health’s payer transparency tools turn this data into actionable insights, optimizing reimbursement, reducing revenue leakage, and meeting patient demands for cost clarity. According to HFMA, leveraging transparency […]
The Payer Spread Index
Unveiling the Payer-Spread Index: How to Unlock Millions in Hidden Hospital Revenue Discover how a simple ratio exposes an average 48% price gap on common inpatient services, and learn how your health system can turn transparency into profit. For a 500-bed hospital operating at 65% occupancy with a 5-day average length of stay (≈24,000 annual DRG admissions), […]
The White House Revives “Most Favored Nation” Drug Pricing Policy: What It Means for Health Systems
On May 12, 2025, President Donald Trump signed an executive order reviving the Most Favored Nation (MFN) pricing model, a bold move to align U.S. prescription drug prices with those in other developed nations, potentially cutting costs by up to 90%. Initially proposed in 2020 but stalled by legal challenges, the MFN policy targets high drug prices […]
The Power of Healthcare Claims data
When healthcare organizations think about real-world data (RWD), claims data is often one of the first sources that comes to mind. But understanding what claims data really is, and how to leverage it strategically can make the difference between simply accessing information and driving measurable performance improvements. Here’s what healthcare leaders should know about claims […]
How Can a 30-Minute Doctor Visit Cost $101 or $660? The Healthcare Price Transparency Problem
In the same U.S. city, a routine 30-minute office visit was billed at $101 by one health system and $660 by another. Same CPT code. Same city. Same service. So what explains a 550% price difference? The answer lies in a growing challenge for hospitals and health systems: lack of visibility into payer reimbursement rates. Why […]