How Health Plans and Payers Increase Efficiency with Gigasheet: Unlocking Savings Through Transparency in Coverage Data

The healthcare industry generates massive amounts of data, and for payers and health plans, one of the most valuable yet underutilized data sources is Transparency in Coverage (TiC) files. These machine-readable files contain negotiated rates between payers and providers, offering unprecedented visibility into the healthcare pricing landscape. However, the sheer volume of this data presents a significant challenge: TiC files can contain billions of rows of pricing information, making traditional analysis tools virtually useless.

This is where Gigasheet helps to transform how health plans operate. By preprocessing, cleaning, and standardizing price transparency data across all major payers in the market, Gigasheet automatically statistically compares rates and benchmarks against competitors. For payers, Gigasheet AI identifies specific opportunities for cost savings with targeted providers and procedures, all without requiring health plans to do the heavy lifting.

The Transparency in Coverage Challenge

Since 2022, the Transparency in Coverage Final Rule has required most group health plans and health insurance issuers to disclose their negotiated rates with in-network providers and allowed amounts paid for out-of-network care. While this regulation promotes price transparency, it has created a data management challenge:

The scale is staggering. A single health plan's TiC file can contain hundreds of millions of rows, with each row representing negotiated rates for specific billing codes, providers, and service locations. For national payers, these files can reach billions of rows across multiple markets.

Traditional tools fail. Excel maxes out at just over 1 million rows. Database solutions require expensive infrastructure, technical teams, and lengthy implementation timelines. Cloud data warehouses involve complex ETL processes and ongoing costs that can quickly spiral.

Health plans need a better way to turn this data into actionable intelligence.

How Gigasheet Processes Price Transparency Data at Scale

For nearly 5 years, Gigasheet has been building tools specifically for big data analysis without the complexity. Here's how health plans are leveraging the platform:

Preprocessed, Cleaned, and Standardized Data

This is where Gigasheet truly differentiates itself. Rather than requiring health plans to upload, clean, and standardize TiC data themselves, Gigasheet has already done the work. The platform preprocesses, cleanses, and standardizes TiC data across all major payers in the market, creating a consistent, analysis-ready dataset.

This means health plans can immediately access:

• Standardized provider identifiers across different payer files
• Consistent procedure code formatting
• Normalized rate structures for apples-to-apples comparisons
• Clean, validated data that's ready for analysis

While users can upload their own data for on-demand processing when needed, the core offering is this preprocessed market data that eliminates months of data engineering work.

Automatic Competitive Benchmarking

Here's where the real power emerges: Gigasheet automatically compares your negotiated rates against all major competitors in your markets. You don't need to hunt down competitor benchmarks, or build comparison models.

Gigasheet's analytics automatically:

• Identifies where your rates are significantly higher than competitors
• Flags specific providers and procedures with the greatest savings opportunities
• Highlights market trends and pricing anomalies
• Surfaces actionable intelligence without manual analysis

This automatic benchmarking transforms what would be a months-long analytical project into instant, ongoing competitive intelligence.

Intelligent Data Exploration

Once you access the preprocessed data, you can dive deeper through an intuitive interface. Filter negotiated rates by specific providers, procedure codes, or geographic regions. Sort by price to identify outliers. Group data to understand pricing patterns across different service categories, all without writing a single line of code.

Identifying Cost Savings Opportunities

With automatically benchmarked price transparency rates, health plans can immediately pinpoint specific opportunities to reduce costs:

Provider-Specific Negotiations

Gigasheet's automatic analysis reveals which healthcare systems or physician groups are charging your plan significantly more than they charge competitors. This creates a data-driven foundation for renegotiating contracts.

Example: A regional health plan used Gigasheet's automatic competitive analysis and discovered they were paying 19% more than competitors for routine office visits with primary care providers at a major hospital system in their market. Armed with this competitive intelligence, they successfully renegotiated their contract, saving millions annually.

Network Development Opportunities

Understanding the competitive rate landscape isn't just about reducing costs with existing providers. It's also about strategic network expansion.

Example: A national network used Gigasheet to analyze physical therapy and chiropractic rates across their coverage areas. The automatic benchmarking revealed markets where competitors had secured significantly better rates, along with gaps in their own network. With Gigasheet's data, they were able to pinpoint high-quality providers in any zip code and offer competitive contracts right out of the gate, aggressively expanding their network with favorable pricing from day one.

Procedure-Level Analysis

Different procedures show different pricing dynamics across the market. Gigasheet's preprocessed data enables health plans to instantly see rate variations by specific CPT codes or DRGs to find procedures where your rates are outliers.

Network Optimization

Understanding the full rate landscape helps health plans make strategic decisions about network design. If a provider charges significantly more than alternatives without corresponding quality differences, you can make informed decisions about network inclusion or tier placement.

Reference-Based Pricing Strategies

For self-insured employers, Gigasheet's market-wide rate analysis supports reference-based pricing approaches by establishing what constitutes a reasonable rate in specific markets.

The Gigasheet Advantage for Healthcare Efficiency

Pre-Processed Market Intelligence

The biggest advantage isn't that you can analyze price transparency data. It's that you don't have to. Gigasheet has already preprocessed, cleaned, and standardized data across all major payers, transforming millions of hours of potential data engineering work into instant market intelligence. You get immediate access to competitive benchmarking without lifting a finger.

Automatic Competitive Analysis

While other solutions require you to manually compare rates across payers, Gigasheet automatically identifies where your rates are out of line with the market. This isn't just faster. It's more comprehensive, catching opportunities that manual analysis would miss.

Speed to Insight

What previously would have taken months of data engineering work (collecting competitor files, standardizing formats, building comparison models) is available instantly. Access Gigasheet in the morning, and by afternoon you're identifying specific savings opportunities and network development targets.

No Technical Barriers

Gigasheet requires no coding, no SQL, and no data engineering expertise. Network managers, actuaries, and contracting teams can directly access competitive rate intelligence without waiting for IT support or hiring specialized analysts.

Zip-Code Level Precision

Whether you're looking to renegotiate with existing providers or expand your network, Gigasheet enables you to pinpoint opportunities at the zip-code level. Find high-value providers in specific markets and approach them with competitive offers based on real market data.

Collaboration at Scale

Share your analysis with colleagues across the organization. Build standardized views for executive reporting. Document your methodology for rate negotiations. Gigasheet's collaboration features ensure that insights flow throughout your organization.

Cost-Effective Solution

Unlike enterprise data warehouses or business intelligence platforms that require six-figure investments and ongoing maintenance, Gigasheet offers a straightforward, affordable pricing model that scales with your needs, without requiring you to invest in data infrastructure or engineering teams.

Beyond Rate Analysis: Additional Use Cases

While TiC data analysis is a primary use case, health plans are using Gigasheet for numerous other efficiency improvements:

• Claims data analysis: Process millions of claims records to identify utilization patterns, detect anomalies, and measure provider performance
• Quality metrics reporting: Combine clinical data with claims data to calculate HEDIS measures and quality scores
• Provider directory management: Maintain accurate provider networks by analyzing and updating large directory files
• Member data integration: Merge data from multiple sources to create comprehensive member profiles for care management programs
• Regulatory reporting: Prepare large datasets for government reporting requirements without manual data manipulation

Getting Started with Gigasheet

Health plans looking to improve efficiency and uncover cost savings through TiC data analysis can get started with Gigasheet quickly:

1. Sign up for a Gigasheet account at gigasheet.com
2. Access preprocessed, standardized TiC data across all major payers in your markets
3. Review automatic competitive analysis to identify where your rates are significantly higher
4. Share findings with contracting teams and executives to drive immediate action
5. Monitor ongoing market changes as Gigasheet continuously updates the competitive landscape

The Future of Healthcare Cost Management

As healthcare costs continue to rise, payers and health plans must leverage every tool available to operate efficiently and deliver value to members and employers. Transparency in Coverage data represents an unprecedented opportunity to understand the pricing landscape and make data-driven decisions about network strategy and provider negotiations.

The challenge has never been access to data. It's been the ability to process, standardize, and analyze that data at scale. Gigasheet removes this barrier by doing the heavy lifting for you, providing instant access to preprocessed, market-wide competitive intelligence.

By automatically analyzing TiC data across all major payers and surfacing specific savings opportunities, Gigasheet is helping health plans across the country identify millions of dollars in cost reductions, negotiate from positions of strength, expand networks strategically, and ultimately reduce healthcare costs for the members they serve.

Ready to unlock cost savings in your health plan? Schedule a demo to see how Gigasheet can transform your rate strategy.

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