Where RBP is winning, where balance billing risk is highest, and which markets offer the largest cost containment opportunity — analyzed from 6,600+ hospital MRF files and Form 5500 employer data.
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Direct PDF Download →A preview of what's in the full report — analyzed from Q1 2026 MRF and Form 5500 data.
32 pages of market-specific data, methodology notes, and actionable guidance for consultants, TPAs, and employers evaluating RBP strategy.
Current state of RBP adoption by market, employer size, and industry. Where momentum is building and where traditional networks still dominate — with data from Form 5500 filings across 35,000+ self-funded health plans.
Hospital rate variance within 50+ MSAs, ranked by spread magnitude. Identifies which markets have the most pricing inefficiency — and therefore the largest RBP opportunity — by taxonomy category.
A market-level risk score based on hospital rate positioning relative to Medicare benchmarks, history of rate volatility, and payer mix context. Essential reading before recommending RBP to an employer in an unfamiliar market.
Which procedure categories — orthopedics, imaging, outpatient surgery, cardiac — show the most consistent savings potential under 130%, 140%, and 150% Medicare thresholds, broken down by market tier.
Which markets have the highest concentration of facilities that are both below market cost and above quality floor thresholds — the conditions required for defensible RBP steerage recommendations.
A practitioner-facing framework for assessing employer readiness: plan design, member communication, repricing partner selection, and quality floor criteria. Designed for consultants and TPAs building client proposals.
The report gives you the market overview. The platform gives you the drilldown — by facility, category, and provider.
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