Use Case / Health Plans

Network Design & Provider Analytics for Payers

Benchmark provider and hospital rates, compare market position, and bring hospital-quality context into contracting conversations without relying on scattered spreadsheets.

The Challenge

Network Strategy Without Market Visibility

Contract Position Visibility

Provider and hospital counts do not reveal where a network is above or below benchmark or which relationships deserve deeper quality-aware review.

Competitive Rate Intelligence

Provider relations teams need to understand whether key facilities and groups are priced above peers before negotiations start.

Provider Contracting

Hospital and specialist contract reviews require rate, footprint, and quality evidence that is usually scattered across many systems.

The Solution

Market Intelligence for Network Strategy

Market Benchmarking
Review hospital and provider benchmark reports side by side and quickly identify cost positions worth contract attention.
Competitive Rate Benchmarking
Compare payer and provider rate positions by category, facility, and market.
Steerage Modeling
Identify high-quality, cost-effective providers and affiliated-hospital pathways for site-of-care discussions.
Quality-Adjusted Rate Analysis
Overlay imported quality metrics with rate data to separate routine price issues from higher-risk negotiations.
Provider Footprint Intelligence
Track provider group expansion, hospital affiliations, and market access changes.
Quality-Aware Routing
Follow provider pathways into value-routing review when affiliated hospitals matter.
Real-World Application

How Payers Use Healthdex

Market Benchmark Review

Scenario: A regional plan preparing for hospital and specialist contract reviews needs one workspace to compare price position, provider footprint, and quality context.

Compare hospital benchmark rows across counties and service categories.
Review provider benchmark contributors.
Open affiliated-hospital routing for selected categories.
Save and export working slices for contracting review.

Result: The contracting team moves from scattered one-off pulls to a repeatable workflow that highlights above-market rows and quality-sensitive pathways.

Rate Negotiation Defense

Scenario: A payer facing a major hospital rate request needs defensible market evidence and alternatives.

Compare commercial rates against other payer positions.
Review imported quality context.
Identify nearby competitors with better cost or quality states.
Create reusable benchmark views for follow-up negotiations.

Result: The team can defend counteroffers with evidence instead of treating each negotiation as a bespoke data scramble.

By The Numbers

Impact for Health Plan Clients

$5.2M
Avg Annual Rate Savings
Hospital + Provider
Benchmark Coverage
92%
Rate Visibility Improvement
Routing
Affiliated-Hospital Review
Platform Capabilities

Built for Network Strategy Teams

Multi-Market Coverage

Analyze markets or custom service areas and compare performance across the network footprint.

Payer Rate Comparison

Filter benchmark rows by facility, specialty, payer, and category to find overpayment opportunities.

Cross-Market Comparison

Compare the same hospital or provider categories across multiple selected markets.

Quality Performance Overlay

Combine rate data with imported hospital-quality signals for value-sensitive conversations.

Workflow Persistence

Save benchmark views, bookmarks, and packets so contracting teams can reopen the same review slices.

Hospital Quality Drilldown

Open imported-quality detail when rate comparisons alone are not enough.

Next Step

Ready to Build Smarter Networks?

Benchmark what nearby competitors are paying, review affiliated-hospital routing paths, and keep contracting analysis in one repeatable workflow.

Request pilot access