We analyze hospital prices at the procedure code level and present an analysis of suggested rate changes designed to enhance the defensibility of proposed pricing with sensitivity to financial impact.
Web-based software that creates custom analyses of financial/operating strengths, weaknesses, and opportunities. Utilizes client-submitted claims data as well as national public-use data.
RESPONSES PROVIDED BY CLEVERLEY + ASSOCIATES July 21, 2025
Recently, CMS released a Request for Information regarding the accuracy and completeness of hospital machine-readable files (MRFs). According to the request, “To meet the President’s Executive Order to ensure compliance with the transparent reporting of complete, accurate, and meaningful data, CMS seeks public input on whether and how CMS can improve hospital price transparency (HPT) compliance and enforcement processes to ensure that...
The old TV program Hee Haw sang a ditty which went, “If it weren’t for bad news, there would be no news at all?”
It seems that is our current situation—we have an unending barrage of world and national news that seems to be negative almost 100 percent of the time. One of the bad news issues that affects the health care industry is legislative efforts to curtail health care spending. Current budgetary discussion seems to be centered on reducing Medicaid spending which in FY20...
On May 22, 2025 CMS released new price transparency information for health plans and hospitals, including guidance for the production of the hospital price transparency machine readable file (MRF). The information release was expected in response to the February 25, 2025 Executive Order which we previously discussed. While the release was expected, there are several things that remain confusing about the hospital MRF provisions. We summarize key elements and outstanding questions below.
&n...
A Cleverley Response to The Price Transparency Executive Order
Some of our clients inquired as to how the recent transparency executive order might affect the current machine readable file template. While the executive order from February 25, 2025, titled “Empowering Patients Through Radical Price Transparency,” affirms this administration’s commitment to price transparency, it does not specify changes to the machine readable file template at this time.
It’s clear that this administrat...