Launching ahead of the CMS Transparency in Coverage rule, partnership aims to scale the positive patient impact of price transparency data
NEW YORK, June 21, 2022 /PRNewswire/ -- Ribbon Health, an API data platform for the healthcare industry that powers care decisions, and Turquoise Health, a leader in delivering structured data on the cost of care to make pricing data both transparent and accessible to patients, announced a partnership today. By integrating Turquoise Health's price transparency data into the Ribbon Health platform, healthcare companies will be able to effectively navigate patients to cost-effective and high-quality care.
For decades, the healthcare industry has provided little insight into health care prices, preventing patients from understanding the price of care in advance of receiving healthcare services—a staggering majority of patients cannot compare medical costs. Recently, the Centers for Medicare & Medicaid Services (CMS) released the Transparency In Coverage Final Rule (TiC) and the Hospital Price Transparency Final Rule, requiring both payers and hospitals to disclose cost of care information via a machine-readable file (MRF). Portions of the Hospital Price Transparency Final Rule are already in effect, with the first, and highly anticipated portion of the Transparency in Coverage Rule—disclosure of payer rates data—going into effect on July 1, 2022. Along with the No Surprises Act, this trio of price transparency legislation was created to help patients know the cost of a covered item or service before receiving care and to prevent predatory billing practices.
In their raw formats, hospital and payer MRFs are not easily understood or actionable given their complexity. To improve the clarity of the data, Turquoise Health uses a combination of healthcare subject matter experts, data engineering, and machine learning. The cost and care insights derived by Turquoise Health enable better alignment and transparency across payers, providers, and patients. With this data integrated into Ribbon Health's provider data platform, companies across the healthcare ecosystem can finally have access to the full picture of provider, network, and cost information all in one place.
"Cost of care is a critical data point that has historically been entirely opaque and inaccessible to patients when deciding where and how to access care," said Nate Maslak, co-founder and CEO of Ribbon Health. "While price transparency legislation is an important step in the right direction, its impact must be measured by the healthcare industry's ability to translate it into action. We are helping drive that impact by enabling better access, cost-effectiveness, and outcomes when navigating patients to care. That means making price information available alongside providers' specialty and focus areas of expertise, quality indicators, the languages they speak, and the myriad of other data elements a patient looks at to find the right provider. By partnering with Turquoise Health, we aim to help payers, providers, and digital health companies access the price transparency data they need to better patients' experiences when making care decisions."
More than half of the records in provider directories are inaccurate, meaning patients often lack the most basic information to access high-quality healthcare. Ribbon Health's comprehensive and real-time provider directory, network, and performance products serve as critical infrastructure for healthcare companies to level up the experience of finding care across the industry. The Ribbon Health platform provides rich insights on providers—from critical information like the correct phone number to more nuanced data like cultural competency and quality of care. Turquoise Health's price transparency data unlocks another layer of granularity for patients, enabling them to make healthcare decisions based on more comprehensive information.
"Improving population health, while delivering quality care at lower costs, is the holy grail of healthcare. Making previously secret prices accessible will have an outsized impact on intelligent care navigation," said Chris Severn, co-founder and CEO of Turquoise Health. "This new data will allow anyone to reliably find high-quality care with upfront prices instead of a leap of faith into the healthcare unknown. Together with Ribbon Health, we have the ability to elevate millions of patient journeys in one single solution."
Ribbon Health and Turquoise Health aim to scale access to price transparency information, as well as address the data inaccessibility and inaccuracies plaguing the healthcare system, like:
"Patients continue to fly blind on their healthcare decisions in the absence of actionable data, including cost estimates," said a16z General Partner Julie Yoo, a member of the Board of Directors at both Ribbon Health and Turquoise Health. "We're excited to see increasing collaboration like this between healthtech infrastructure companies, in this case, to enable care delivery organizations and consumers to more readily access the data they need for navigating the healthcare system–including insight into care providers, networks, locations, quality, and cost—in a single place."
Founded with the mission to simplify healthcare, Ribbon Health is an API data platform and solution for the healthcare industry. Ribbon Health is focused on providing healthcare enterprises with services to augment their provider data, enabling them to present patients with accurate and consumer-centric information for high-quality, personalized care decisions.
Founded in 2016 and inspired by co-founders Nate Fox and Nate Maslak's personal experiences with the healthcare system, Ribbon Health aims to empower every patient's care decision to be convenient, cost-effective, and high quality. To learn more about Ribbon Health's suite of solutions, visit www.ribbonhealth.com.
Since its founding in 2020, Turquoise Health has aggregated and organized pricing data for over 4,500 hospitals, amounting to over 1B records. By combining prices with quality scores, claims data, and provider directories, Turquoise Health is building a new way to power a transparent marketplace that works for providers, payers and patients. Turquoise Health recently announced a Series A funding of $20M from Andreessen Horowitz, Bessemer Venture Group, Box Group, and Tiger Global and is frequently featured in The Wall Street Journal, The New York Times, Axios, Fierce Healthcare, Business Insider, and other major media publications.
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SOURCE Ribbon Health