How Large Health Systems Are Using Payor Price Transparency to Inform Strategy, Negotiations, and Expansion

Jennifer Keller • March 30, 2026

Payor Price Transparency data has quickly become one of the most powerful (and to date, underutilized) strategic assets available to health systems. While the value of this data is often discussed in terms of contract negotiations, the potential extends far beyond that.

To better understand how forward-thinking health systems are putting this information to work, we sat down with Abraham (Abe) Gage, SVP, Chief Strategy Officer at UofL Health in Kentucky. In partnership with After Transparency, Abe and his team have begun leveraging payor transparency data to strengthen negotiations, evaluate market expansion opportunities, and support strategic investment decisions.

The takeaways from this conversation highlight how organizations can start using transparency data to drive meaningful financial and operational impact.

As Blake Madden, healthcare strategist and founder of Hospitalogy, notes: “Given the scale and level of volumes in all kinds of specialties and service lines, hospitals and health systems hold the biggest opportunity in leveraging Payor Price Transparency data. Rate negotiation is really just the beginning. Over time, as systems move from siloed thinking toward an enterprise-wide mindset, we’re going to see strategy, finance, and even marketing teams infuse transparency data over a broad range of use cases.”

Our conversation with Abe confirmed exactly that. Below are several high-impact areas where health systems like UofL are already unlocking value.

1. Strengthening Contract Negotiations

For many Providers, the most immediate opportunity lies in Payor contract negotiations. Historically, negotiations have been shaped by a Provider's limited visibility into market rates, forcing them to rely heavily on Payor assertions about network pricing.

Transparency data changes that dynamic. As Abe explains: “Payor Price Transparency data is the most valuable and transformative source of competitive intelligence available to health systems today—and a critical asset as hospitals work to stabilize financial performance and plan for the years ahead.” 

With access to After Transparency’s data portal and the strategic insight and analytical support of our team, UofL can now benchmark its reimbursement rates against competitors and validate Payor claims during negotiations. UofL can finally have truthful, meaningful conversations with its Payors based on facts.

For example, one Payor repeatedly told UofL it was already receiving the highest reimbursement rates within its Kentucky network. But after an investigation and review by Abe and After Transparency, this assertion was debunked.

Armed with actual market data, including specific reimbursement figures for nearby hospitals, UofL was able to challenge the claim and reframe the negotiation around verified facts. The result was a more productive line of conversation and measurable progress toward a fair reimbursement. 

With After Transparency’s help, UofL Health has reduced a reimbursement gap with a key competitor from 9% to 5%.

2. Evaluating New Market Opportunities

Payor Price Transparency data is also proving valuable for health systems considering expanding services or entering new markets. Opening a new clinic or service line requires significant upfront investment, and understanding reimbursement dynamics in advance can help determine whether the move is financially viable.

UofL has used After Transparency’s data to evaluate opportunities such as free-standing imaging centers in new locations. By analyzing reimbursement trends in a target market, Abe’s team can now determine:
  • What Payors are currently reimbursing for specific services
  • The specific rates in that geography
  • Whether proposed contracts will cover operational costs
This insight has allowed the UofL contracting team to approach Payors with clear expectations regarding the reimbursement rates required to sustain a new facility. Rather than accepting low initial proposals, the team can negotiate from a position of informed confidence. 

As a not-for-profit health system, UofL Health isn’t seeking excessive margins; it simply needs reimbursement levels that allow it to sustainably deliver care. Payor Price Transparency data, when paired with the right analytics partner, like After Transparency, will ensure those financial assumptions are grounded in real market conditions.

3. Evaluating ROI for Expenditures and Investments

Another emerging use case involves strategic investments in quality programs and service-line development. This came into play for UofL Health as they weighed the pros and cons of participating in the BlueCross BlueShield Distinction Programs.

Through analysis conducted with After Transparency, UofL Health identified meaningful reimbursement differences between hospitals that participated in these programs and those that did not. These insights allowed them to begin evaluating whether participation would generate a meaningful return on investment for their hospital.

The team was able to model several critical variables:
  • Upfront and ongoing program participation costs
  • Expected patient volumes tied to Payor programs 
  • Reimbursement deltas associated with distinction status
By simulating these scenarios, UofL Health can project the potential financial return of participating in quality programs before making significant operational commitments. Many times, once they run the numbers, it’s a no-brainer for them to move ahead with these initiatives.

Why This Matters Now

These types of insights are especially important in today’s financial environment. Large health systems, and particularly safety-net and not-for-profit organizations, must carefully allocate limited resources while continuing to expand access to care.

Better intelligence about reimbursement markets allows leadership teams to make those decisions with greater confidence. Instead of relying on assumptions or incomplete information, organizations can now model financial outcomes using real market data.

The After Transparency Approach 

At After Transparency, we’ve seen firsthand how many health systems are approached with solutions promising operational improvements or revenue gains, often requiring large commitments before any value is proven. Our approach is different.

Our strategy is to start small, show value, and scale over time. Rather than asking organizations to overhaul their strategy overnight, we start with a focused, high-impact use case. This might involve a single Payor, service line, geography, or contract negotiation.

By concentrating on one measurable opportunity, health systems can quickly see tangible results. On average, organizations working with After Transparency experience greater than 10x ROI from their initial use case. From there, the data foundation can expand.

As After Transparency co-founder Jon Bruser explains: “The end goal is a system-wide approach to optimizing Payor reimbursement data, which will result in cost savings, streamlined operations, and improved care quality. As the value you see from After Transparency grows, so will our partnership.”

Using this initial analysis as a baseline, After Transparency will:
  • Establish a robust Payor reimbursement dataset that covers more of your business
  • Advise you on how to utilize this data to drive better decision-making and financial outcomes
  • Expand data applications across other markets and business units
And as Blake Madden of Hospitalogy puts it: “Over time, we will see countless use cases emerge for transparency data as provider organizations move from siloed to enterprise-wide strategic thinking. Don’t get left behind.”

If you’re ready to explore what’s truly possible or simply want an informed conversation about the possibilities available to your organization, connect with our team today. Come discover the After Transparency difference. Reach out to us here.  

Note: After Transparency is honored to be included in one of Hospitalogy's "10 Healthcare Consulting Reports Worth Reading.” Blake Madden originally shared aspects of this post in October 2025 in his Hospitalogy newsletter, which you can subscribe to here.

While you’re at it, join the thousands of healthcare professionals who already get expert analysis on healthcare M&A, strategy, finance, and markets. Subscribe to Hospitalogy, created by Blake Madden, at hospitalogy.com. 

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