Medlyze cuts through ‘noise’

NEW YORK – Medlyze Technologies, which recently partnered with AAHomecare to develop a payer transparency portal, cuts through complexity and reveals the true costs of health care, says Wayne Carlson. 

“It’s a lot of information and there’s a lot of noise in that information,” said Carlson, co-founder and CTO. “Our passion is around getting insights out of data because a lot of companies don’t know what to do with it.” 

Medlyze, which launched in 2021 in anticipation of newly implemented federal rules requiring transparency in pricing for health care, has developed a portal for AAHomecare with data from more than 60 major commercial insurers to help providers understand payment rates and trends. 

Carlson spoke with HME News about how simplifying complex data can help providers get to “a level playing field” when it’s time to renegotiate payer contracts. 

HME News: What does Medlyze do?  

Wayne Carlson: We make it easier to integrate and analyze the price transparency data. We actually get into hospital, payer, inpatient, outpatient, drug price and claims data from payers and employers and health care quality data and we provide solutions to host this large set of data and then automate analytical systems and deploy AI to drive even more deep insights. And then of course, we develop executive dashboards to facilitate decision-making, which is really more speaking to how AAHomecare has used our services. 

HME: How did you customize these solutions for the HME market? 

Carlson: We worked very closely with AAHomecare’s payer relations team and Payer Council. I spent a year designing a fit-for-purpose benchmarking solution for the DME market. We collected the DMEPOS-specific negotiated rates for over 50 players across the nation. We then benchmarked each billing code by payer and geographies and presented it in the easy-to-use dashboard. Members can see current rate distributions for billing codes.  

HME: How do you hope HME providers can use this in their businesses? 

Carlson: On the one hand, (I have) a great sense of optimism that objective data and insights can be used by providers to improve their contracted rates and financial viability. On the other hand, providers also find it daunting and an uphill climb to renegotiate their contract. So, we're empathetic to the challenge of operating. 

HME: Why is transparency in health care data so important? 

Carlson: Ultimately, transparency engenders a culture of trust among health care stakeholders. Trust is essential to designing a win-win outcome between providers, payers and patients. Furthermore, having transparent data gets us all closer to a level playing field and equitable financial arrangements for essential health care services.