Leveraging the Transparency in Coverage Reimbursement Data
Presented by Nicholas Newsad
Recorded on Wednesday February 11th, 2026
This program is 60 minutes and is valid for 1 CHBME credit.
Description:
This presentation highlights new commercial reimbursement data made publicly available by commercial insurance carriers under the federal Transparency in Coverage rule. Differences in commercial reimbursement are visualized for real physician enterprises, hospitals, surgery centers, and other organizations. Reimbursement rates in Georgia, New York, Texas, California, and other states are explored. This new era of transparency not only affects managed care professionals but also creates all sorts of interesting new possibilities for finance and financial forecasting, strategic planning, new service line development, and entrepreneurship.
Learning Objectives:
Course participants will be able to:
- Understand the impact of geography, insurance network size, healthcare organization size, and national contracts on negotiated reimbursement rates
- Understand the difference in "Medicare markups" for different types of services and specialties
- Understand the differences in rates from state-to-state
Speaker Bio:
Nicholas Newsad, MHSA, is the Vice President of Innovation at the national healthcare consulting firm Coker and author of the book Doctor Deals. Over 20 years, he has been involved in over 400 major healthcare business transactions. He has prepared reports for the California Attorney General, DOJ, IRS, Indian Health Service, Medicare AdministrativeContractors, hospitals, health systems, physicians, and private businesses.
Nick has presented at events sponsored by the American Health Law Association, AmericanBar Association, Colorado Bar Association, California Bar Association, and HealthcareFinancial Management Association on healthcare industry topics. He has been interviewed in AARP: The Magazine, Consumer's Digest, New York Daily News, LA Times, Healthcare FinanceNews, Money.MSN.com, FoxBusiness.com, Woman's World, Richmond Times, Tampa Tribune,Rochester Post, Utah Daily Herald, Cincinnati Business Journal, Pittsburgh Health Report, and other publications.