High-Value Opportunities You’re Missing for Acquisitions, Service Line Expansion, and More

Healthcare leaders have no shortage of priorities competing for their attention. Between shrinking margins, rising labor costs, reimbursement uncertainty, cybersecurity threats, and the growing influence of AI, most executives don't have time to chase every new technology or dataset that promises better financial performance.

That's one reason payor price transparency data is often overlooked. For many providers, it's viewed as just another new, untested tool for contract negotiations. Jacob Rodman, CEO of Raleigh Neurosurgical Clinic (RNC), understands the disbelief. Like most healthcare executives, he's heard countless promises from vendors over the years—many of which never delivered. "There's a natural skepticism for people in my position," Rodman says. “90% of the things I’ve ever been told were going to generate more revenue for us just didn’t.”

What ultimately changed his mind on price transparency data was his introduction to After Transparency, where he quickly observed what he called “a different approach.” After Transparency helped him to identify the many unexpected, yet practical ways transparency data could help his team make better operational and strategic decisions. 

His willingness to give this data a shot quickly paid off. Not only was RNC able to immediately apply this data to a payor negotiation, securing an additional $600,000 in annual reimbursement (more on that story here), but, just as importantly, it’s proven helpful in evaluating acquisitions, expanding service lines, and addressing unfair physician compensation. 

In this post, we'll share several ways RNC has used payor price transparency data beyond contract negotiations. Their experience demonstrates that when providers have better visibility into reimbursement, they can make informed improvements across their organizations. 

Using Transparency Data to Expand Services with Confidence

For years, Raleigh Neurosurgical Clinic partnered with an outside anesthesia group that served the practice well. But as they continued to grow, Rodman and his team began asking whether bringing anesthesia in-house could create a better experience for both physicians and patients.

Their goal wasn't simply to replace an existing model. They wanted to build an MD-only anesthesia service that would give patients greater continuity of care while creating a more efficient surgical workflow. The challenge wasn't deciding whether to make the change—it was determining whether the numbers would support it.

"I had no idea what to ask for when it came to anesthesia billing," Rodman says. "It was all brand new to us. We'd never done it before. I didn't know what was reasonable, how to bill it, or which numbers we needed to make the pro forma work. We weren't trying to make money on anesthesia, but we couldn't afford to lose money either."

Without historical contracts or benchmarks to guide them, the financial side of launching an in-house anesthesia service was unfamiliar territory. Working with After Transparency, RNC used payor price transparency data to understand what payors were actually reimbursing for anesthesia services so they could establish realistic reimbursement expectations before moving forward.

Instead of relying on assumptions, his team now had objective data that helped them build a financial model they felt confident in. The results have extended well beyond their expectations.

Since bringing anesthesia in-house, RNC has increased surgical case volume by approximately 20%, largely through improved efficiency. The same anesthesiologist now evaluates the patient before surgery and remains with them throughout the procedure, eliminating handoffs and helping the surgical team work more seamlessly together. Patients are also recovering more quickly after surgery, with anesthesia providers able to manage wake-up and recovery more consistently.

Looking back, Rodman considers bringing anesthesia in-house one of the practice's most successful operational decisions. Price transparency data didn't make the decision for them, but it gave them the confidence to expand a service line they otherwise may have hesitated to pursue, and the improvements have benefited both the practice and its patients.

Making Smarter Acquisition and Expansion Decisions

Over the years, pain clinic acquisition and the identification of new market opportunities have become an important part of RNC’s long-term growth strategy. But every expansion decision carries risk, and Rodman has long wanted a way for his team to have clear insight into a clinic's reimbursement landscape before moving forward with any new deal.

Historically, RNC has relied on third-party consultants to analyze managed care contracts and assess whether a potential acquisition made financial sense. This process depended on the clinic being evaluated having easy access to its payor contracts—a hurdle that proved more common than Rodman expected.

"I'd ask them to send their contracts to this third party, but they didn't have them," Rodman says. "They didn't know how to access them, or they couldn't pull them from their system. We ran into that issue over and over again."

With their After Transparency partnership and the insights derived from payor price transparency data, RNC has uncovered a better way to evaluate opportunities. Instead of waiting on contract reviews or outside analysis, they can use transparency data to assess a clinic’s payor mix, reimbursement trends, and overall financial picture much earlier in the process. 

Rodman admits the idea initially gave him pause. “It just seemed like such a foreign concept to be able to do this,” he says. But after confirming with the organization's legal team that using publicly available transparency data in this way was entirely appropriate, RNC began incorporating the analysis into its acquisition process. The difference has been significant.

RNC added two clinics last year and is already evaluating additional opportunities. More importantly, Rodman says his team now approaches each opportunity with a much clearer understanding of what they're buying. 

"As we make these acquisitions, we feel more confident," Rodman says. "It's easy for us to break down the financials and understand how the clinics stand. We can see their payor mix and how it compares with ours. This data just simplifies the whole process."

Bringing this analysis in-house has also accelerated decision-making. Rather than waiting weeks for outside evaluations, RNC can review reimbursement data internally, ask deeper questions, and perform the level of analysis his team wants before deciding whether to move forward. As Rodman puts it, "It's not that I didn't trust our third party—they've always provided good information. But I'd rather see the data for myself and with our team so we can do the full analysis that we want to."

Addressing an Imbalance in Physician Reimbursement

As RNC has strengthened its relationships with several hospital partners through value-based enterprise agreements, those partnerships have created new opportunities to better understand the financial side of patient care. By combining information shared through these relationships with payor price transparency data, the practice has been able to perform a much more complete contribution margin analysis—giving them insights that simply weren't available before.

One example involves one of RNC’s neurosurgeons whose work focuses on complex, life-changing procedures. Although this surgeon's professional reimbursement had long seemed lower than expected, it was difficult to understand why without seeing the broader financial picture.

Through open conversations with one hospital partner and insights from transparency data, RNC was able to compare physician reimbursement alongside what hospitals were being reimbursed for those same procedures. That context changed the conversation.

"Once we connected with After Transparency, we realized we could determine our entire contribution margin based on the cases he was handling at those institutions," Rodman says. "For a stroke intervention, for example, this surgeon might receive around $700 while the hospital is billing $50,000."

Rodman is quick to point out that this represents one of the more dramatic examples they've encountered, not the norm. And he acknowledges that hospitals have legitimate reasons for receiving higher reimbursement, including facility costs, staffing, equipment, and other operational expenses that physician practices don't bear.

Still, having visibility into the complete reimbursement picture has helped RNC better understand where meaningful gaps exist and where there may be opportunities for more balanced physician compensation. Rodman and his team can now pursue more informed, collaborative conversations about physician reimbursement. 

They also have a better idea of what to expect and what would be considered a win when it comes to more balanced pay for RNC’s surgeons. As Rodman puts it, "It would be huge for us to even reach 50% of the total fee schedule. That would be considered a success."

Looking Beyond Contract Negotiations

Rodman understands the skepticism many healthcare leaders feel about payor price transparency data. Practices have spent years hearing promises about new data portals and tools that will solve reimbursement challenges or create new revenue opportunities, only to come away disappointed. But he’s seen something different in his experience with After Transparency and the way RNC has been able to leverage price transparency data.

“People need to know how valuable this data is,” Rodman says. “I think so many people in my shoes will just turn down this data before they really understand it. But this data, and our partnership with After Transparency, has delivered for RNC. And I know without a doubt that it can deliver for other practices like ours.”

For RNC, this data has led to better negotiations, to be sure. But it’s also enabled smarter expansion decisions, better physician reimbursement, and greater confidence in strategic planning. “In an environment where private practices feel increasingly vulnerable, this data and partners like After Transparency give me hope,” says Rodman. And after uncovering so many applications for its use, he’s been on a mission to share RNC’s wins with others. 

As financial pressures continue to mount across healthcare, transparency data can help providers make better business decisions across their organizations. It’s a real opportunity for healthcare providers to gain a sure footing and set their practice on a path that will allow them to stay strong and viable for many years to come. 

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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.