On many fronts, Raleigh Neurosurgical Clinic (RNC) is thriving. For more than 60 years, the practice has served patients across North Carolina and built a reputation as a trusted destination for head, neck, back, and spine care.

Today, RNC includes 11 board-certified or board-eligible neurosurgeons supported by a growing team of physician assistants and nurse practitioners. But despite its growth and strong reputation, the practice faces a reality familiar to many independent providers: increasing financial pressure. It’s not an exaggeration to say they’re fighting for survival. 

They're not alone in this struggle. Independent practices have seen a massive 48.5% decline in ownership since 2018, according to Becker’s Physician Leadership. Between reimbursement inequities and ongoing prior-authorization challenges, independent practices like RNC are being squeezed from every angle. 

To better understand how RNC is navigating these pressures, After Transparency spoke with CEO Jacob Rodman about the strategies his team is pursuing to keep the practice financially stable while continuing to deliver exceptional patient care. Our conversation naturally centered on their use of payor price transparency data, which is a resource Rodman had once dismissed but now sees as a critical tool for protecting the future of independent practices. 

For Rodman, the priority for their practice is straightforward: patient care. “Ultimately, all that matters is delivering great patient care,” he said. “We want to continue serving our community for as long as we can.” 

Today, he believes transparency data is helping make that mission sustainable by giving independent practices a stronger position at the negotiating table and renewed confidence that they can remain financially viable, keep their doors open, and continue caring for the communities that depend on them.

Curious About Transparency Data, but Cautious About the Investment

Rodman first became aware of payor price transparency data several years ago. Like many healthcare leaders, he was intrigued by the promise: access to negotiated reimbursement rates that could help practices better understand their market position and make more informed business decisions. But his interest quickly gave way to hesitation.

Hype about this new data was everywhere, followed closely by vendors offering access to aggregated data portals and insights. But price points often ranged from $50,000 to $100,000. For an independent practice, that kind of investment, especially with an unknown return, just wasn’t in the cards. 

“At the time, you didn’t know what you’d actually get from the data,” Rodman said. “It felt like too big a gamble for a practice like ours to take.” 

He was also hearing rumors that the data wasn't usable without a master’s-level analytics person on staff. Even the data curated by data companies was hard to apply, and many providers felt duped by the experience. So while his interest was initially piqued, he also dismissed it pretty quickly. 

Taking Another Look

The conversation about payor price transparency data resurfaced when Rodman connected with After Transparency. He agreed to an introductory conversation and quickly sensed a different approach. The offering from After Transparency felt practical, approachable, and attainable for a practice of RNC’s size. After Transparency offered access to payor price transparency insights that could yield meaningful results for their practice. It felt like an offer too good to pass up.

From the start, After Transparency delivered insights that proved to be game-changing for RNC, including a high-level snapshot of RNC’s reimbursement position alongside the professional rates across its market. Because RNC operates in North Carolina’s Research Triangle—home to major academic health systems and research institutions—it was expected to see higher reimbursement among those organizations. “We realize that when payors negotiate with large, multibillion-dollar health systems, they will offer a more advantageous rate than what they offer our independent practice,” Rodman said.

But it was eye-opening to see how poorly their reimbursements compared with those of other private neurosurgery groups across the state. “For the first time, we had confirmation of just how under-reimbursed we were,” Rodman said. “It was discouraging and demoralizing.”

Seeing comparable services reimbursed at dramatically different levels created a clearer picture of the challenge RNC had been feeling for years. “It’s hard to see the same service at a practice down the road delivering less than ideal outcomes being reimbursed almost twice as much as we are for the same CPT code,” admitted Rodman.

Turing Insight Into Action

Once the team saw the data, they decided to apply it directly to an upcoming payor negotiation involving their ambulatory surgery center (ASC). RNC’s ASC operates independently and is physician-owned. Unlike hospital-affiliated ASCs that may benefit from broader system contracting leverage, RNC negotiates without those advantages.

RNC’s negotiating strategy has always been to lead with honesty and a partnership outlook. “From our perspective, we feel we should be working together with our payors to deliver the best possible outcomes and care,” said Rodman. RNC leads with what it believes is a compelling value story: its strong track record of saving payors' money while delivering a better customer experience, better outcomes, lower infection rates, and quicker discharges. Historically, however, these payor conversations often reached the same conclusion.

“The response is usually, ‘No one in your market is getting the rates you’re asking for,’” Rodman says. In the past, they had no way to push back. The reality is that without visibility into actual reimbursement benchmarks, negotiations are one-sided, and the payors hold all the cards. 

But with After Transparency, RNC has negotiating power for the first time. “Once we can say, ‘We have data,’ the conversation changes almost immediately,” Rodman says. “Suddenly it becomes a much more informed discussion.” Payors quickly adjust their strategy and return ready to engage in a more sincere dialogue about the requested numbers. 

The Result: Meaningful Financial Impact

RNC’s first negotiation using insights from After Transparency resulted in approximately $600,000 in additional annual reimbursement from a single payor. For a practice of RNC’s size, that kind of impact is significant. At the time, that represented roughly an 8% increase in annual revenue.

“We operate on small margins, so that’s a meaningful lift,” Rodman said. He also emphasized that his goal in payor negotiations isn’t to secure exceptional treatment; it’s to pursue fair reimbursement. “I’ve never asked for something I didn’t believe others were already receiving,” he said. “Now we have more confidence in understanding what the market actually looks like, and we can advocate for reimbursement that reflects the value of the care we provide.”

He added that independent practices don’t expect parity with large academic health systems. “We know we’re not a multi-billion-dollar health system and we don’t expect to be reimbursed exactly the same way,” Rodman said. “But getting closer to fair market reimbursement helps ensure independent practices can continue delivering high-quality care.”

Looking Ahead

For Rodman, transparency data represents more than negotiation leverage—it represents possibility. RNC can only fill the financial gap to a point through higher patient volume. “There are only so many hours in the day, and our team is willing to do the work,” Rodman said. “We just need reimbursement that reflects the high-quality care we deliver.” Without increased reimbursement, they can’t keep up with the financial demands their practice is facing.

“In an environment where private practices feel increasingly vulnerable, this data and partners like After Transparency give me hope that the future can look different,” he said.

He’s also on a mission to let other private practices know what’s possible with payor price transparency data. “My colleagues in private practice are out there trying to survive and thrive, which gets harder and harder every year,” Rodman said. “They need to know this is available and they can actually get it themselves. They need to know there’s a company that will support them in the process so we can all continue to be here to change lives.” 

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Let’s Talk: After Transparency is a Nashville-based analytics firm that decodes federally legislated payor transparency data—transforming massive, complex datasets into precise intelligence. We’re an analytics partner, not a data dump. We work directly with clients to understand their strategic priorities, payor mix, geography, and key codes, then deliver clear, decision-ready insights clients can act on immediately. Book a meeting with us today to learn how we can put payor price transparency data to work for you.

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