WhatA SaaS platform that ingests CMS cost reports and computes real cost-to-charge ratios by hospital, ownership type, and procedure, giving employers and benefits consultants actionable pricing intelligence.
SignalThe analysis reveals that nonprofit hospitals mark up nearly 4x actual costs, and commercial insurers pay 2.5x what Medicare does — but this data is buried in raw government filings that almost nobody processes systematically.
Why NowThe Hospital Price Transparency Rule (2021) and the Transparency in Coverage Rule (2022-2023) now require hospitals and insurers to publish machine-readable pricing files, creating a massive new data layer that is public but largely unusable without tooling.
MarketSelf-insured employers (60%+ of covered workers), benefits consultants, and TPAs paying $1.5T+ annually in commercial claims; competitors like Turquoise Health and PayerPrice exist but the market is early and fragmented.
MoatCompounding data asset — building longitudinal cost-to-charge ratio databases across thousands of hospitals creates a pricing intelligence layer that improves with each year of CMS data ingested.
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