Market Intelligence Redefined

See What Payers Actually Pay Before You Negotiate

The only platform combining provider footprint intelligence with actual negotiated rates from transparency data. Make data-driven decisions on M&A, network strategy, and cost containment.

Columbus MSA - Hospital Rates

DRG 470 - Joint Replacement
$28,450
35th %ile
Market Median
$32,100
+12.8%
Rate Variance
42%
High opportunity
6,600+ Hospitals Analyzed
50+ Healthcare Markets
100K+ Provider Groups
Real-Time Negotiated Rates

Healthcare's $3 Trillion Blind Spot

Health Systems

Evaluating acquisition targets using 2-year-old cost reports and rumors about rate structures. Flying blind on what payers actually pay them.

Payers

Tracking provider counts by specialty but don't know if you're overpaying for thin coverage. Adequacy reports pass regulatory tests but members still complain.

TPAs

Building high-performance networks on gut feel and outdated data. Can't quantify which providers to steer toward in each market.

Market Intelligence + Actual Rates

We've built the only platform that answers: "What provider options exist in this market, what do they actually charge, and how does that compare?"

1

Hospital MRF Data

See actual negotiated rates for top DRGs across 6,600+ hospitals. Know what payers pay before you negotiate.

2

TiC Payer Files

Provider group rates from major payers (BCBS, Aetna, Cigna, UHC). Benchmark by specialty and geography.

3

Market Footprint Analysis

Understand provider presence, group affiliations, specialty coverage, and geographic distribution.

Rate Distribution - Orthopedic Surgery

Hospital A
Hospital B
Hospital C
Hospital D
Hospital E
Green = Below Market Median | Blue = Above Market Median

Three Personas, One Platform

Identify Undervalued M&A Targets

See actual negotiated rates alongside market footprint, quality scores, and specialty coverage. Know before you negotiate.

  • Target Scoring: Composite metrics on rate efficiency + quality + market position
  • Competitive Intelligence: What payers actually pay your competitors
  • Service Line Analysis: Cardiology, orthopedics, oncology market views

Example: Columbus Acquisition Target

Rate Efficiency Score Below Market
Quality Score (CMS) 4-Star
Market Position Mid-Size
Acquisition Tier Tier 1 Target

Stop Overpaying for Thin Networks

Map your network coverage against actual rates you're paying vs market benchmarks. See where you're both underserved AND overpaying.

  • Network Gaps: Identify specialties with thin coverage + high rates
  • Rate Variance Alerts: Flag when paying >2x market median
  • Strategic Recruitment: Prioritize where to add providers

Example: Cardiology Coverage

Providers per 100K 15.2 (Low)
Avg Rate vs Market +38% (High)
Access Score Below Standard
Priority Level Urgent Action

Build High-Performance Networks with Data

Identify cost-efficient provider groups by specialty with proven quality scores. Prove ROI to employer clients.

  • Steerage Opportunities: Show where to redirect members for 20-40% savings
  • Episode Cost Modeling: Quantify savings by specialty and market
  • Benchmark Reporting: Client performance vs market standards

Example: Orthopedic Network

Cost Efficiency 28% Below Median
Quality Score Above Average
Projected Savings $2.4M Annually
Network Tier Tier 1 Preferred

Everything You Need to Understand a Market

Market Selection

Choose from 50+ MSA markets or define custom geographies. Work in one market context at a time for focused analysis.

Hospital Intelligence

Actual negotiated rates by DRG and payer. Quality metrics, bed counts, discharge volumes, system affiliations.

Provider Groups

Footprint analysis, specialty composition, MIPS scores, rate benchmarking where TiC data available.

Provider Profiles

NPI-level data with group affiliations, practice locations, specialty, medical school, quality metrics.

Rate Benchmarking

Market medians, percentile rankings, payer-specific comparisons, outlier detection, variance analysis.

Export & Reporting

Excel, PDF, PowerPoint exports. Board-ready snapshots. Custom reports. API access for Enterprise.

Choose Your Plan

Starter
$3,500/month
For small teams exploring market intelligence
  • 10 markets (user-selectable)
  • Hospital + provider group footprint
  • Basic rate benchmarking
  • Market overview dashboards
  • Excel & PDF exports
  • 3 named users
  • Email support
Get Started
Enterprise
$25,000/month
For large organizations with national scope
  • Unlimited markets
  • API access for integrations
  • White-label reporting
  • Custom data integrations
  • M&A scoring / steerage modeling
  • Custom dashboards
  • Data refresh SLAs
  • Unlimited users
  • Weekly strategy calls
Contact Sales

90-Day Design Partner Pilot Available - Get started with zero cost or 50% discount. Limited slots.

Ready to See What Payers Actually Pay?

Join our 90-day design partner pilot. Work with real data in your markets. Provide feedback. Convert only if you see value.

Request Pilot Access

Or schedule a 15-minute demo: team@healthdex.com