Cleveland, OH RBP Market Intelligence

Public-safe Healthdex signals for evaluating reference-based pricing opportunity in the Cleveland market, using OPPS-backed Medicare benchmark coverage, positive threshold-category signals, and Ohio balance-billing risk context.

Market-Level Signals With Enough Coverage To Be Useful

14
Hospitals with supported categories
12
Ratio-ready hospitals
9
Positive threshold-category signals
27,958
Supported negotiated-rate rows

OPPS Categories Driving Cleveland RBP Review

Read RBP overview
Category Ratio-ready hospitals Median to Medicare Above thresholds Benchmark rows
Specialty Drug Management
Pharmacy / Drug Spend / pharmacy
11 1,831% 11 / 11 / 11 2,460
Rehab / Wound Optimization
Site of Care Optimization / outpatient_hospital, cross_setting, professional
11 207% 11 / 11 / 11 9,286
Infusion Site Optimization
Site of Care Optimization / pharmacy, cross_setting
11 207% 11 / 11 / 10 11,491
Imaging Optimization
Site of Care Optimization / cross_setting
12 192% 10 / 10 / 10 1,715
Sleep Management
Utilization Management / cross_setting
11 157% 9 / 9 / 8 1,234
Lab Optimization
Site of Care Optimization / professional
11 146% 9 / 9 / 2 1,424
Emergency Department Review
Payment Integrity / Bill Review / outpatient_hospital
1 405% 1 / 1 / 1 128
Diagnostic Testing Optimization
Site of Care Optimization / cross_setting
1 243% 1 / 1 / 1 77

How To Use This Market Page

  • Counts are market-level directional signals, not employer-specific savings guarantees.
  • OPPS-backed CPT/HCPCS categories are public here; inpatient MS-DRG benchmark work remains signed-in analyst workflow.
  • Threshold counts show hospitals above modeled Medicare percentages across supported categories.
  • Resolved ZIPs with thinner local coverage may still use a broader market or statewide fallback in the public estimator.

Review Cleveland RBP Fit

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