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.
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.
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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...
A Closer Look At Hospitals Costs with Our Founder, Bill Cleverley
I have been in the hospital industry as both a professor and consultant for 51 years. One thing that has never changed in these 51 years is that healthcare and hospitals in particular have been singled out for rising costs—which, translated, means that healthcare and hospitals are absorbing a greater percent of our nation’s Gross National Product (17.6%) in 2023.
I may be old, but I have heard about Artificial Intelligen...
What Will Die Hard Cost John McClane?
Every year the question is presented— is Die Hard a Christmas movie, and every year two opposing camps form. The first strongly believes that it is, in fact, a Christmas movie, and the second one is wrong. But that’s not what we’re here to discuss today!
We’re here to discuss what the injuries John McClane sustained in Die Hard would cost for him and his local hospital. We here at Cleverley + Associates can’t weigh in on a dislocated shoulder, but we are ...