Ensure Full Compliance with CMS Hospital Price Transparency

Generate CMS-compliant MRFs and shoppable services—powered by AI, delivered without technical burden.

NEW Free CMS Compliance Checker (Beta)

Instantly scan any hospital website to check for CMS Price Transparency compliance: MRF file, correct link placement, and shoppable services availability.

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Currently in beta. For informational use only. Results may be limited by site structure or technical restrictions.

Transforming Healthcare with PayerAnalytics

Meeting CMS Hospital Price Transparency requirements can be complex. PayerAnalytics simplifies it. Our platform automates the creation of CMS: compliant Machine-Readable Files (MRFs), generates consumer-friendly shoppable service tools, and keeps your hospital compliant through every mandate update.

Streamline Compliance

PayerAnalytics reduces the administrative challenges of price transparency. Focus on patient care while we handle compliance complexities, helping you meet regulatory requirements with ease.

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Optimizing Your Rates

Our benchmarking technology not only ensures compliance but also provides clear insights into market rates. Use these insights to refine pricing strategies, enhance financial margins, and drive revenue growth.

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Understanding CMS Mandates

Hospital Price Transparency

The CMS Hospital Price Transparency rule requires hospitals to publicly disclose standard charges, including negotiated rates with payers. Compliance involves publishing machine-readable data and meeting phased deadlines to ensure full transparency.

Key Deadlines:

July 1, 2024: Align Machine-Readable Files (MRFs) with CMS templates, including new data elements like gross charges, discounted cash prices, and payer-specific negotiated rates.

January 1, 2025: Add elements such as estimated allowed amounts and detailed drug information.

Rate Renegotiation

PayerAnalytics uses CMS Transparency in Coverage data to help hospitals benchmark rates and identify opportunities for renegotiation. This enables hospitals to optimize pricing strategies, improve margins, and streamline operations.

For example, one provider negotiated a rate of $63,783 for a service, while another provider negotiated $168,480 for the same service under the same plan. Such disparities highlight significant opportunities for renegotiation and revenue growth.

Our platform provides comprehensive rate benchmarking for any provider, offering insights into market positioning, pricing strategies, and contract optimization, ensuring competitive advantage in the healthcare market.

About PayerAnalytics

PayerAnalytics is a CMS compliance platform developed by Cranberry Peak Corp. It enables hospitals to create, validate, and publish compliant Machine-Readable Files and shoppable services tools. It also includes built-in tools for rate benchmarking and contract insights, helping hospitals remain competitive once compliance is achieved.

Feature Highlights

Rate Benchmarking

Discover how PayerAnalytics can transform your hospital's financial performance with our powerful benchmarking tools. Our platform analyzes market rates, helps optimize pricing strategies, and ensures you stay competitively positioned.

Example of Negotiated Rates:

DRG 454: Combined Anterior/Posterior Spinal Fusion Without Complication or Comorbidity/Major Complication or Comorbidity (CC/MCC).

The chart reveals striking differences in negotiated rates for this specific service. Hospital A has a rate of $168,480 with Payer 1 and $135,529 with Payer 2. Comparatively, Hospital B's rates are $63,783 with Payer 1 and $92,064 with Payer 2. These discrepancies highlight the significant opportunities for rate renegotiation and revenue enhancement.

With PayerAnalytics, you can benchmark these rates effectively and optimize your pricing strategies to maximize your hospital's financial outcomes.

Contact Information

For more information or to schedule a demo, please contact us:

Additional Resources

Download our whitepapers and detailed guides to learn more about how PayerAnalytics can help your hospital navigate CMS mandates and optimize rate benchmarking.

View Example of Shoppable Services

Frequently Asked Questions (FAQ)

The CMS Hospital Price Transparency rule requires hospitals to publicly disclose their standard charges, including negotiated rates with payers for services. This rule aims to provide patients with clear and accessible information about healthcare costs.

Hospitals must conform their Machine-Readable Files (MRFs) to the CMS template layout by July 1st, 2024. Full compliance, including additional elements like estimated allowed amounts and detailed drug information, is required by January 1st, 2025.

Non-compliance can result in substantial penalties. Smaller hospitals (30 or fewer beds) could be fined $300 per day, while larger hospitals are subject to $10 per bed per day, with a maximum of $5,500 daily. This can total up to $2,007,500 per year. CMS also publishes the names of non-compliant hospitals, which can damage their reputation.

Benchmarking negotiated rates helps provider organizations optimize their pricing strategies, increase financial margins, and improve operational efficiency. By analyzing market comparisons, hospitals can identify opportunities to enhance revenue and streamline operations.

PayerAnalytics provides a comprehensive solution that simplifies compliance with the CMS Hospital Price Transparency rule. Our platform helps hospitals publish the required data in machine-readable formats and ensures all regulatory requirements are met efficiently. Additionally, PayerAnalytics leverages data published under the CMS Transparency in Coverage Rule to support hospitals in benchmarking their negotiated rates and optimizing their pricing strategies.

Contact us to schedule a demo and see how PayerAnalytics can work for you. Our team will guide you through the process and help you navigate the CMS mandates efficiently.