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Solutions for Payers

In today’s constantly changing healthcare landscape, payers are looking to provide obtainable, efficient, and quality healthcare to their members, improving performance and growth through actionable, data-driven insights.

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Actionable Real-World Data

Informed Network Design

Provider Information

Understand Member Populations

Assess Plan Accessibility

Price Transparency

Fetching data-backed answers to strategic questions

We are your trusted real-world data partner, answering key questions including:

Where are my providers sending patients in-network and out-of-network?

Do I have correct addresses for providers practicing at multiple locations?

Where are my members seeking care outside of my network?

How do I compare to key competitors in the market?

What locations, types of care should I invest in?

What providers can I add to my network?

Is my network ‘leaking’ patients and can I assess why?

Is there the right mix of specialities in my provider network?

How do our negotiated rates with providers compare to competitors’ rates for the same services?

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Who’s On for Compliance? Navigating Healthcare Price Transparency and the Current Regulations

The healthcare industry is undergoing a seismic shift as price transparency regulations gain momentum, driven by executive orders and federal rulemaking. These regulations aim to empower patients with actionable pricing information and foster accountability among healthcare providers and payers. However, enforcement challenges and data complexities have revealed gaps that need innovative solutions. In this article,…

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Questions? Ready for a demo or free trial of our healthcare analytics platform, HealthNexus™?
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Actionable Real-World Data

Empower your organization by working with unified, secure, and validated claims data, enabling real-time analysis of provider benchmarking, patient journeys, price transparency and market performance, ultimately fostering data-driven strategies that improve health outcomes.

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Informed Network Design

Strong network performance stems from data-driven decision-making. Leverage claims data (including Medicare, Medicaid and commercial sources), SDOH and real-world evidence to transform your network performance evaluations, competitive analyses and identify key growth opportunities.

  • Assess cost and quality metrics
  • Analyze volumetric growth drivers, market demand, network adequacy
  • Work with trusted provider data intelligence and volumetric summaries 
  • Users can easily convert patient and provider populations to dollars. Assess market size and overall revenue potential as well as understand market penetration and share of opportunity.

Provider Information

Prioritize a single source of truth to support provider directory accuracy, understanding hospital structure, provider scoring data and referral patterns both in and out of network.

Centralized and simplified insights on 6.4 Million healthcare practitioners and 1.8 million healthcare facilities allow organizations to connect the dots between provider behaviors and competitor dynamics.

Discover best-in-class Provider Data Management solutions

Understand Member Populations

Improving health outcomes starts with understanding your member population. HIPPA compliant patient data powers robust SDOH reporting to answer critical questions including:  

  • What types of providers are my members seeing and how are those providers performing?
  • Where are my members being referred to?
  • What access barriers are they facing?
  • What chronic conditions may affect a specific member population?
  • How can I improve the measurement of adherence patterns and outcomes?
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Learn more about our SDOH Data

Assess Plan Accessibility

Analyzing the member journey can provide key indicators of network performance. Where are you members going? Are they having to go out-of-network for care? Are members leaking out-of-network because of quality related reasons?

Evaluate your network and market share dynamics through referral patterns, provider scorecards and other data insights.

Price Transparency

The complexities and opacity of price transparency data make it difficult for decision-makers to find actionable insights.

Whether you’re analyzing payer MRFs or hospital MRFs, just having access to the raw data is not enough to inform key decisions, such as rate negotiation, repricing strategies, and network expansion or recruitment opportunities.  

PurpleLab’s Trusted Price Intelligence solution unlocks the value of price transparency by integrating payer and hospital MRF data with longitudinal claims data and industry-leading referential data sets, delivering a complete financial picture with real-world clinical insights.

Evaluate your network and market share dynamics through referral patterns, provider scorecards and other data insights.

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