CDM Market View

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Moving Beyond “Guesswork” in Healthcare Pricing

For decades, hospital pricing strategies were often reactive—matching a competitor’s rate from last year or applying a flat percentage increase across the board. In today’s consumer-driven, regulatory-heavy environment, those old tactics are liabilities. Hospitals today face a dual threat: Underpricing leads to immediate revenue leakage and unsustainable margins, while Overpricing damages reputation and drives patients to competitors. Pricing is no longer just a financial exercise—it is a competitive necessity. PMMC’s Online Market Analytics empowers your organization to stop guessing and start leading.

Determine the right price for every HCPCS/CPT code by synthesizing multiple benchmark criteria into a single, powerful view
Leverage your Chargemaster against customized market data, Medicare reimbursement rates, and actual cost structures
Transform raw data into a strategic asset. Online Market Analytics eliminates the blind spots in your pricing strategy. Instead of relying on anecdotal evidence or outdated surveys, you gain access to a dynamic engine that computes results based on the criteria you value most.

Online Market Analytics bridges the data gap. Whether you need to solve for competitive positioning or cost-recovery, the software handles the heavy lifting, allowing your revenue integrity team to focus on strategy rather than data entry. The result of using Online Market Analytics? A defensible, competitive pricing strategy that protects your margins while ensuring market relevance.

Lead the Market, Don’t Just Follow It

There is a distinct difference between “matching” the market and “leading” it. Online Market Analytics is designed for organizations that want to set the pace.

When you only match competitors, you are essentially letting them dictate your financial strategy. You are reacting to their moves, often months after they have made them. Online Market Analytics flips this dynamic.

By leveraging real data and advanced analytics, you can identify areas of opportunity before your competitors do. You can:

Find codes where the market is significantly underpriced relative to cost and adjust to capture margin.
Identify high-visibility “shoppable services” where a slight price reduction could drive significant volume.
Transform your department from a back-office function into a strategic engine that drives the hospital’s financial health.

True market intelligence requires context. It is not enough to know what you charge; you must understand how that charge resonates in your specific ecosystem. Online Market Analytics offers robust capabilities to compare your prices against a triad of averages: Local, State, and National.

This multi-layered approach ensures you aren’t operating in a vacuum.

Local Level: Understand the immediate pressures from the hospital across town.
State Level: Gauge regional trends and regulatory impacts.
National Level: See how your facility stacks up against broader industry standards.
Peer Comparisons: If your pricing for a DRG is higher than a competitor’s, is it because your room rates are higher, or because you are using more expensive supplies? This report tells you.

By utilizing these benchmarks, you can instantly visualize how your charges stack up. Are you an outlier? Are you leaving revenue on the table in a niche service line? Online Market Analytics answers these questions instantly, giving you the confidence that your pricing reflects your organization’s value and market position.

Generic data leads to generic strategies. Your hospital faces unique pressures from a specific set of competitors, which may vary by service line. A “one-size-fits-all” market report often dilutes the data with irrelevant facilities that don’t impact your volume.

Market View+ allows you to curate your own reality. You can create customized views that are populated only with the specific competitors you view as direct rivals.

Select Specific Peers: Choose the exact hospitals you compete with for patients and payer contracts.
Filter Out Noise: Remove facilities that distort the average but don’t impact your market share.
Targeted Comparison: Compare your charges directly against this bespoke group to see true competitive parity.

This feature is critical for strategic planning. When you present pricing changes to leadership, you aren’t presenting data based on a generic “state average”—you are presenting data based on the five hospitals that actually matter to your bottom line.

High-level averages are useful for executives, but Revenue Integrity and Pricing Analysts live in the details. Averages can hide significant variances that affect reimbursement. Market View+ provides built-in analytical tools that strip away the complexity of big data, allowing for streamlined analysis across multiple dimensions.

We provide the flexibility to slice and dice pricing data by:

Hospital: Isolate data for individual facilities within a larger system.
Service Category: Look specifically at high-volume areas like Radiology or distinct surgical lines.
DRG (Diagnosis Related Group): Analyze pricing from an inpatient perspective to ensure bundled profitability.
Room Rates: Ensure your daily accommodation charges align with local standards.
CPT/HCPCS & Medicare APC: Drill down to the code level, including specific Medicare Ambulatory Payment Classification values.
MSDRG & Case-Mix Adjusted: We offer comparisons available by both MSDRG and Case-Mix Adjusted Service Line.
Visual Clarity: Data is presented in graphical charts for quick trend identification, backed by detailed table views for root-cause analysis.

This granularity prevents “broad strokes” pricing that inadvertently hurts specific departments. You can be aggressive in areas where you offer premium value and conservative in highly commoditized service lines.

Save Hundreds of Hours of Manual Research

While there are many ways to get comparative data these days, traditional market analysis is still grueling. It often involves expensive consultants or skilled analysts spending weeks managing massive spreadsheets and manually cross-referencing CPT codes that may have changed since the last update. Online Market Analytics automates the grunt work. We estimate that Online Market Analytics saves teams hundreds of hours annually. This is time that can be reinvested into revenue integrity audits, denial management, and other high-value activities that directly impact the bottom line.

Eliminate Manual Comparisons

No more staring at Excel rows for hours. The system automates the matching and comparison process.

Instant Reporting

What used to take a week to compile now takes minutes.

Focus on Strategy

Free up your analysts to interpret the data rather than gathering it.

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Seamless Integration with CDM Pricing+

Pricing strategy cannot exist in a silo separate from your Chargemaster (CDM). That’s why our PMMC consultants integrate Online Market Analytics data directly with your CDM.

This hands-on approach is a gamechanger for workflow efficiency. Our experts work with you, using live market data alongside your operational data to ensure your pricing strategy is always actionable and ready for immediate implementation.

All-in-One Platform

Access your market intelligence and your active Chargemaster in one place.

Actionable Insights

When you identify a pricing opportunity in Online Market Analytics, you can move to execute that change within the CDM environment fluidly.

Data Integrity

Because the systems talk to each other, you reduce the risk of transcription errors or version control issues that plague manual processes.

CDM Pricing Software

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Market Coding Comparisons

Every hospital is unique. You may offer specialized oncology treatments or advanced robotic surgeries that your local competitors do not. Traditional benchmarking often fails here because it tries to compare “apples to apples” when you are selling “oranges.”

Online Market Analytics provides intelligent Market Coding Comparisons that easily identify services or procedures that are unique to your hospital—or conversely, unique to other hospitals in your market.

Identify gaps in your service by analyzing what competitors are billing for that you aren’t—this could reveal new service line opportunities. Protect niche pricing by pinpointing codes where you are the sole provider, allowing for value-based pricing adjustments without impacting competitive perception. Additionally, ensure coding compliance by comparing your coding patterns with the market to avoid using retired or uncommon codes that differ from industry standards.

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The Cost of Inaction

Price transparency rules have armed patients and payers with more data than ever before. Media outlets are scrutinizing hospital charges, and patients are “shopping” for non-emergent care.

Remaining passive regarding your pricing strategy is a risk you cannot afford.

Reputational Risk: Being an unexplained outlier in price can damage community trust.
Revenue Risk: Pricing below market rates for complex procedures means subsidizing payers and losing margin.
Compliance Risk: Maintaining a defensible, rational pricing methodology is key to regulatory compliance.

Online Market Analytics provides the defensibility you need. It allows you to document exactly why a price was set, referencing the specific benchmarks and cost data used in the calculation. It turns pricing from a liability into a documented, strategic process.

Stop reacting to the market and start defining it.

Join the leading healthcare organizations that use PMMC’s Online Market Analytics to drive revenue, ensure compliance, and build defensible pricing strategies.

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Online Market Analytics

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