Healthcare Price Intelligence · Self-Funded Employers

Your PPO network is probably
costing you more
than cash pay.

Openbook Health delivers rigorous price transparency analysis for self-funded employers — revealing the gap between what you're paying and what you could pay.

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590%
Avg. PPO rate vs. Medicare
for outpatient surgery
$1.58M
Savings identified
for a 2,000-life plan
271%
True cash-pay rate
vs. Medicare baseline
Price Transparency Self-Funded Employers Direct Contracting ERISA Fiduciary Duty MS-DRG Analysis Cash-Pay Optimization Stop-Loss Strategy Benefits Intelligence Price Transparency Self-Funded Employers Direct Contracting ERISA Fiduciary Duty MS-DRG Analysis Cash-Pay Optimization Stop-Loss Strategy Benefits Intelligence

The network your broker sold you is working
against you.

PPO networks were designed to give insurers leverage — not to save your plan money. In most cases, "negotiated rates" are still multiples of what a self-funded employer with the right intelligence could pay directly.


Federal price transparency rules now require hospitals to publish their actual rates. Openbook translates that data into actionable savings intelligence — before your next renewal.

590%
Outpatient surgery billed at 590% of Medicare under a standard PPO chargemaster — before "negotiation"
Rate Comparison — Outpatient Surgery
PPO Negotiated Rate590% Medicare
Cash-Pay Rate (direct)271% Medicare
Medicare Baseline100%
Based on Openbook analysis for a 2,000-covered-life plan.

From claims data to direct savings.

Three phases. Concrete numbers at every step. No guesswork, no generalities.

Phase 01
Price
Discovery
We pull your claims data alongside hospital price transparency files to map every procedure against what cash-pay actually costs at your target facilities. No assumptions — published rates only.
Phase 02
Gap
Analysis
We quantify the spread between your current PPO rates and available cash-pay or direct-contract rates, procedure by procedure, facility by facility. We express it in dollars, not percentages.
Phase 03
Steerage &
Negotiation
We build a pilot procedure list, clinical steerage framework, and direct contracting playbook. You walk into your next renewal — or your first direct contract — with data the hospital's CFO hasn't seen you use before.

What the data
actually showed.

Every engagement produces a specific, defensible savings number — grounded in published hospital data and ERISA-aligned fiduciary analysis.

Outpatient Surgery
Colonoscopy, EGD, limited echo — validated cash-pay pilots
−54%
Sleep Studies
High-volume procedure with significant cash-pay gap
−61%
MS-DRG Restructure
Inpatient direct contracting vs. PPO chargemaster
−46%
Case Study · Confidential
$1.58M
In projected annual savings identified for a 2,000-covered-life self-funded employer — based on shifting select outpatient procedures to validated cash-pay rates.
Plan size2,000 covered lives
Current outpatient rate590% Medicare
Cash-pay rate271% Medicare
Results based on published hospital price transparency data and Openbook analysis. Individual results may vary.

Built for the people accountable
for benefits spend.

Self-Funded Employers
You bear 100% of claims risk. You deserve 100% of the price intelligence. Openbook gives HR and Finance leaders a defensible basis for every benefits decision.
  • 200–5,000 covered lives
  • ERISA fiduciary compliance support
  • Renewal negotiation intelligence
Benefits Brokers & Advisors
Differentiate your book with data-driven transparency analysis. Bring your clients a savings finding before renewal — and they never question your value again.
  • Fiduciary advisor partnerships
  • White-label analysis available
  • Health Rosetta-aligned methodology
Stop-Loss & Captive Carriers
Price transparency intelligence reduces your exposure. Openbook's procedure-level analysis helps underwriters and captive managers price risk with precision.
  • MS-DRG procedure benchmarking
  • Cash-pay pilot validation
  • Reference-based pricing support

We built Openbook because
we found the gap.

Openbook Health was founded after a simple, uncomfortable discovery: for a 2,000-life self-funded employer, the "negotiated" PPO rates were consistently — and significantly — higher than cash pay. The employer was paying more by being in the network.

We built a Services-as-Software model to make this intelligence operational, not theoretical. We don't sell software licenses. We deliver findings, frameworks, and fiduciary cover — so plan sponsors can act on their legal obligations with confidence.

Openbook works at the intersection of federal price transparency data, direct contracting strategy, and ERISA fiduciary best practices. We keep our client roster small and our analysis precise.

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Find out what your plan
is actually paying.

Free initial analysis for qualifying self-funded employers. We'll run your top procedures against published hospital rates and show you the gap.

TYPICALLY RESPONDS WITHIN 24 HOURS · SOUTH FLORIDA BASED · SERVING EMPLOYERS NATIONALLY