At a conference late last month, I witnessed a trend we’ve been preparing for: For the first time, presenters on the mainstage were discussing the importance of self-funded alternative health plans. Read more.

We recently looked at rates for 10 hospitals in and around Atlanta, measuring rates from Aetna, UnitedHealthcare and Blue Cross for a diagnostic colonoscopy. 

Inside the city, Aetna rates ranged from $2,891 at Northside Hospital and Grady Health Systems to $4,353 at Emory St. Joseph’s Hospital and $4,126 at Emory University Hospital Midtown. Outside Atlanta proper, Aetna prices ranged from $2,704 at Piedmont Fayette to $4,353 at Northside Hospital Gwinnett. 

On the whole, Aetna rates are lower than UnitedHealthcare, which ranged from $2,880 at Grady in the city to $5,272 for the procedure at Wellstar Cobb Medical Center in Austell. But UnitedHealthcare returned more consistent rates: Of the 10 hospitals, 4 came out to $3,792, with 4 more at $3,425.    

Six of those hospitals returned rates from Blue Cross Blue Shield ranging from $3,136 (Grady) to $3,933 (Northside). Read more.

These days, you can’t talk about data, or tech, without addressing artificial intelligence and LLMs. Every organization in the world is focused on integrating AI into their business processes as quickly as possible, but in the healthcare setting, we need to really think about strategy and how we can work alongside AI to deliver better outcomes. Read more

Scott Colquitt recently joined Handl focused on the payer side of the healthcare equation. Scott most recently worked in payer sales at Office Ally, and he has experience at Clarify Health Solutions, Optum Health and Cambia Health Solutions.

At Handl, he’s focused on showing carriers how we can help them create dynamic copay health plans that enable …

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When healthcare price transparency regulations first rolled out, the industry became hyper-focused on compliance metrics: Who published MRFs? How many files existed? Which carriers and providers were participating?

At the time, that made sense, because the assumption was that more published data would lead to a clearer understanding of healthcare pricing. Then we actually started working with the data.

What became obvious very quickly is that compliance and usability are not the same thing. A file existing doesn’t automatically make it useful. Some MRFs contain highly reliable negotiated rate data with strong provider and plan coverage. Others are sparse, inconsistent, structurally difficult to interpret, or are missing enough context that the output becomes misleading if used at face value.

Today, the more important conversation isn’t whether a file was published. It’s whether the data is reliable enough to support real decision-making.

So if you’re just getting into price transparency data, remember: MRFs are not a monolith. Every MRF varies in terms of data quality and fidelity based on the organization that’s providing the data, the vendor being used to generate the file, and a host of other factors. As a general rule, larger national carriers and health systems tend to produce more stable and complete transparency data. But when you move down the line, the data gets a little murky.

That’s why the strongest pricing analyses don’t rely on MRFs alone. They combine transparency data with additional context like claims experience, Medicare reimbursement benchmarks, utilization patterns, and normalization logic to build a more accurate view of healthcare pricing.

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Scott and Ahmed just returned from an insightful few days at AHIP, discussing alternative health plan designs with the payers in attendance. They explained how Handl enables carriers to design and activate variable copay plans without an infrastructure overhaul.

Later this month, Sean Trainor, Handl’s lead data analyst, will give attendees at Out-of-Pocket Health’s Data Camp an in-depth look at price transparency data and how to create real insights from information that can be frustratingly hard to parse.