Get rates-based intelligence with Zelis.

Unlock the value of contracted rate data to deliver insights that advance your market position and keep your networks and pricing competitive.

Why Zelis?

Stay competitive through deep market insights.

With the Transparency in Coverage Rule, over a billion new rates-based data sets are now publicly available via machine-readable files, giving payers the opportunity to make strategic decisions based on market contract pricing data. However, the data on its own is messy, incomplete, and hard to use. Do you have the tools readily available to make strategic decisions based on this new data? Now you can.

Unlock the value of contracted rate data to deliver insights that empower a range of plan functions including network, provider contracting, finance, strategy, and sales. Healthcare Insights 360SM is a suite of provider data and analytics services built on Zelis’ expertise in provider, network, and rate data. Bringing complementary data sets and our reputation of delivery in the MRF space together, we give you a competitive advantage to build, access, and manage competitive, cost effective, and compliant networks.

Key Points

  • Seamlessly meet compliance requirements.
  • Inform network design with market insights on cost and quality.
  • Easily understand the impact of contract changes on total cost.
  • Compare INN rates with peers across the market to the service level.

How It Works

“Healthcare Insights 360 is your gateway to unlocking the competitive advantage of the price transparency data. Through our extensive price analytics expertise, we’ve built an advanced solution that can deliver on-demand, actionable insights for our clients.”

— Larry West, Chief Data Intelligence Officer for Zelis

Platform Overview

Set limits on rising healthcare costs while empowering members.

Develop, manage, and sell smarter and more adaptable networks through a 360-degree view of your provider network as compared to your markets.

Explore solution

Get full MRF file management or customize a solution, from data management, data analytics, and member experience solutions for meeting the Transparency in Coverage rule.

Explore solution

For Finance

Better understand how your cost position compares to the market to hone financial planning and expansion discussions. Flexible, guided report configuration makes it easy to set up a new analysis to fit your needs. You can quickly change parameters and see the impact on your results.

For Network Operations

Understand opportunities and risks around your INN contracted rates as compared to the market to support provider contracting and negotiation. Easy navigation between report views to dig deeper into the analysis and uncover key insights.

For Strategy & Intelligence

Make strategic decisions for geographic-based plan growth, like entering or exiting markets, based on cost and provider performance. Clear data visualizations make it easy to understand complex data and provide a view into the distribution of providers by billing class, specialty, and geography across data sources.

For Sales & Marketing

Leverage pricing data to showcase plan value and win deals by quantifying product value and demonstrating how your plan offers the best price for common services.

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Let’s talk about modernizing your business.

There’s no shortage of ways we can help. Get a conversation going with one of our Solution Advisors and build a thoughtful approach aligned to your business goals.

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