Top 5 Turquoise Health Alternatives & Competitors 2024

The Healthcare Price Transparency Act and the Lower Costs, More Transparency Acts passed at the end of last year aim to protect patients by ensuring they can compare the costs a range of hospitals charge. These laws expand the pro-consumer principles established by the No Surprises Act of 2022. At this time, physician groups are not mandated to post their prices for public access. 

With consumers leveraging price transparency to win more decision power in their healthcare choices, software solutions like Turquoise Health have stepped in to help them: 

• evaluate healthcare options
• make choices that align with their needs and finances
• get the lower rates that arise from more competition
• avoid surprise medical bills
• get more access to care (as prices come down and more locations are listed) 

Some healthcare pricing engines – like Turquoise Health – also support providers and payers. For these entities, they provide:

• nationwide price comparisons
• a platform to demonstrate compliance with consumer transparency regulations
• pricing data and boilerplate contracts to expedite rate negotiations between payers and providers

Price transparency engines and the revenue cycle

After starting with a focus on listing prices, many of these companies have expanded to provide additional revenue cycle optimization services like good faith estimate generation, contract management, transparency compliance, and advanced analytics. The expansion has caught the attention of management services organizations and physician groups looking to improve the revenue cycle. 

Here, you can review exactly what Turquoise Health and its alternatives offer and how they can help you streamline operations, control labor costs, and improve revenue as the healthcare industry modernizes via the adoption of advanced technology. 

What is Turquoise Health and what markets does it serve?

Founded in December 2020, newcomer Turquoise Health has established itself as a leader in healthcare price transparency, offering a comprehensive platform that promises to simplify medical costs.

Turquoise Health's primary offering is its search engine, which serves as a starting point for users to compare the costs of care across healthcare services and providers. This consumer-friendly website allows patients to shop for care based on upfront pricing, much like they would for retail goods. 

Beyond serving individual consumers, Turquoise Health has expanded its reach to cater to healthcare organizations, including providers, payers, employers, and life sciences companies. The company's platform now supports several points in the payer and provider revenue cycle, all powered by AI. The platform leverages the pricing data made available through recent federal regulations.

Turquoise Health's product suite includes: 

• Clear Contracts - Organizes and manages contracts, amendments, and terms in one place. Leverages AI to help staff find contract terms in seconds. Analyzes and organizes payer contract performance in tables for quick determination of highest and lowest performers. 
• Clear Rates Data: This product provides access to over a trillion records of hospital, payer, professional, drug, and device rates. It includes an easy-to-use dashboard for exploring markets, service codes, and payer/plan data, allowing users to view, filter, and benchmark custom slices of payer data.
• Compliance+: This suite helps healthcare providers become fully compliant with CMS 1717-F2 regulations while offering patients a simple browsing experience. It includes Compliance Software, MRF creation, and estimate tools to handle CMS requirements efficiently.
• Instant GFE - generates, manages, and delivers good faith estimates (GFEs) in compliance with the No Surprises Act. It allows providers to create accurate out-of-pocket estimates by calculating facility, physician, and additional fees, while also enabling collaboration between multiple providers and facilities for complex procedures. The service aims to streamline the GFE process, improve patient trust through upfront cost information, and ensure providers meet regulatory requirements efficiently. 
• Analytics: Leveraging their database of pricing information to provide insights and benchmarking for healthcare organizations. Their visual analytics reports help you compare location, physician and payer performance by facility level, service category, codes, and yield.
• Standard Service Packages (SSPs):  a free, beta, open-source library that gathers all medical services, materials, and fees associated with a healthcare procedure and represents them as a single code.

Turquoise encourages clients to use several of these products together to fully optimize revenue, increase patient satisfaction, and comply with government regulations. 

 Turquoise Health has no reviews listed on G2, Software Advisor or Capterra. 

List of top 5 Turquoise Health alternatives

• MD Clarity
• HST Pathways 
• Healthcare Bluebook
• Rivet
• PayrHealth

A comprehensive contract management and GFE solution 

MD Clarity

Description

MD Clarity helps healthcare organizations collect optimal revenue while cutting costs. Launched over 10 years ago, it has built its solutions from the ground up to document and parse all contract details. Contract management experts, MD Clarity counts some of the largest American healthcare systems among its clients.  

Contract management

MD Clarity’s advanced contract management and marketing tool RevFind automates centralization, analysis, tasks, and reports for the most complex contracts. Large provider groups and MSOs executing many specialties across multiple locations and states depend on it. Unlike competitors, MD Clarity's team handles the contract uploading work, significantly limiting administrative burden for clients. Its reports measure contract performance, ranking payers to reveal the true value derived from each. 

RevFind also offers a robust underpayments identification solution. Leveraging contract data, RevFind automatically compares payer actual payments against those contracted. It lists these underpayments in a report so that staff can start work ready to contact payers with all the critical information. Providers find significant revenue opportunities when they analyze underpayments by CPT code, provider, location, and payer.

Discovering which payers underpay the most affords you contract negotiation fuel. This proactive approach can lead to millions in revenue recovery.

Patient payment or good faith estimates

MD Clarity’s other product, Clarity Flow, excels at simplifying and automating patient payment estimates. The No Surprises Act of 2022 mandates that providers and hospitals create good faith estimates for all patients paying in cash. Clarity Flow does everything RCM staff used to handle. It:

•  checks eligibility via clearinghouses
•  verifies benefits by patient
• creates tailored estimate letters
•  sends estimates upon appointment booking 
• monitors care deposit collections 
• transfers collected funds directly to the provider’s account

Automated processes relieve staff burdens and make additional hires unnecessary. The few complex estimates that require special attention go to the provider for manual processing. This high level of automation in eligibility verification and estimate generation alleviates the operational burden on healthcare organizations.

MD Clarity features in common with Turquoise Health

Both MD Clarity and Turquoise Health offer contract management and modeling, good faith estimate, and compliance solutions. Both companies provide proprietary software point solutions rather than end-to-end RCM solutions. For instance, neither handles prior authorizations or charge capture solutions the way a Waystar or Experian does. Point solutions engineers create more comprehensive solutions to the myriad of issues that occur at each individual revenue cycle point.  Point solution providers go deep on a few RCM tasks where end-to-end solutions can only treat all the points in the revenue cycle superficially. 

Differences between MD Clarity and Turquoise Health

While MD Clarity and Turquoise Health have similar products, they began their companies with different missions. Turquoise Health initially aimed to get provider prices to consumers and grew to curate a large database so all could have access to prices. MD Clarity started out wanting to get accurate care cost estimates to patients and fair payments for services to providers. Its product iterations focus on ensuring those two goals are met. Turquoise Health focuses on data and provides that data to all players in the healthcare sphere: providers, patients, payers, and even life sciences or biotech companies. While MD Clarity targets fair provider reimbursements and upfront costs to patients, Turquoise Health aims to enhance overall transparency in all healthcare transactions.

Take a quick, self-guided tour through MD Clarity’s powerful contract management and underpayments identification tool, RevFind:

Ratings

Recently, Built-In recognized MD Clarity as a Best Place to Work. MD Clarity also made Inc. Magazine’s 2024 list of the 5000 fastest-growing private companies in America. 

G2 reviewers have given MD Clarity an average of 4.8 / 5 stars from 12 reviews.

A Turquoise Health competitor focused on ASCs

HST Pathways

Description

HST Pathways is an end-to-end software solution for Ambulatory Surgery Centers (ASCs) only. An end-to-end RCM software provider, it manages the entire case lifecycle, from patient scheduling to post-surgery recovery, designed to streamline operations and improve efficiency in ASCs.

With over 1,700 ASC customers and 70,000+ users relying on their solutions, HST offers modules for financial management, clinical operations, patient estimates and payments, scheduling and collaboration, and data analytics.

The company has been recognized for its excellence, winning the 2024 Best in KLAS Award and being named the 2024 ASC Software of the Year by Healthcare Tech Outlook. HST Pathways focuses on helping ASCs address current challenges such as increasing competition, stagnating reimbursements, staffing shortages, and rising costs through efficient, data-driven, and proactive operations.

In the HST Pathways product suite are: 

• HST Practice Management is a surgery center management solution designed specifically for Ambulatory Surgery Centers (ASCs). It offers a range of features including efficient task management, improved supply chain management, and tools to strengthen revenue cycles. The platform provides powerful financial visibility through reporting, maximizes revenue through integrated claims solutions, and offers true case costing to optimize resource allocation. 

• HST Profit Forecast is a comprehensive case profit estimation solution. It automates and simplifies the process of calculating case profitability, allowing ASCs to quickly assess the profit margins of scheduled procedures. The tool integrates with existing HST solutions or other practice management systems to pull relevant data, enabling users to set cost assumptions, establish auto-flagging settings, and generate case profit margins within seconds. 
• HST Data Stream is a comprehensive raw surgery center data solution. It provides a flexible way to access and analyze operational, financial, and clinical data from ASCs, allowing users to connect this data to business intelligence tools for creating custom dashboards and reports. The service offers features such as BI tool connection, daily or hourly data loads, HIPAA compliance, and the ability to store data in AWS S3 buckets. By centralizing data and providing real-time access, HST Data Stream aims to help ASCs make informed decisions, improve profitability, and easily meet compliance requirements.

• HST Patient Engagement is a comprehensive solution designed to enhance patient communication and streamline pre-operative processes. The service offers two key features: a customizable online pre-assessment tool that allows patients to complete their health history forms remotely, and a two-way texting system for automated reminders and direct patient communication. By automating data collection, providing risk flagging capabilities, and enabling seamless patient interaction, HST Patient Engagement aims to reduce cancellations, improve patient safety, and save time for ASC staff, ultimately transforming the patient experience before surgery.
• HST eChart is an electronic medical record (EMR) solution. It offers concurrent charting capabilities with LiveEdit™ technology, allowing multiple clinicians to update patient charts simultaneously in real-time, enhancing collaboration and patient safety. The system provides customizable configurations, HIPAA compliance, e-prescription functionality, and integrates seamlessly with HST's surgery center management solution. By streamlining clinical workflows, improving chart completion rates, and offering real-time data sharing, HST eChart aims to boost operational efficiency and accelerate revenue cycles for ASCs. 
• HST Case Coordination is a comprehensive scheduling and care communication solution. It offers features such as advanced block time management, real-time case updates, and a mobile app for on-the-go access, enabling ASCs to streamline their scheduling processes and improve communication among staff, physicians, and vendors. The service includes capabilities like broadcast scheduling to share open OR times, document storage, digital surgery boards, and HIPAA-compliant chat tools, all aimed at increasing operational efficiency and enhancing patient care. By automating scheduling tasks and facilitating seamless communication, HST Case Coordination helps ASCs reduce case cancellations, improve staff efficiency, and potentially increase revenue.
• HST Clariti is a patient estimate solution that creates accurate and automated estimates for scheduled patients. It offers features such as insurance verification, case estimation, and electronic delivery of estimates to patients via text or email. The service aims to boost pre-payments, reduce payor denials, and improve office efficiency while ensuring 100% compliance with the No Surprises Act. With capabilities like progressive estimations, insurance checking, and integration with various payment and scheduling systems, HST Clariti helps ASCs streamline their financial processes and enhance patient satisfaction.

• HST Pay is an integrated patient payment solution designed to streamline billing processes and improve efficiency. It offers automated payment posting to HST Practice Management, reducing manual data entry and minimizing errors. The service provides multiple payment options for patients, including online, phone, and in-person payments, supporting various payment methods such as credit cards, electronic checks, and health savings accounts. With features like secure cardholder data protection, quick refunds, and integration with other HST solutions, HST Pay aims to enhance patient satisfaction and simplify financial operations for ASCs.

Features HST Pathways shares with Turquoise Health

HST Pathways and Turquoise Health both depend heavily on data to improve the provider revenue cycle. Both also offer good faith estimate (GFEs) solutions.

Differences between HST Pathways and Turquoise Health 

Apart from GFEs, HST Pathways and Turquoise Health have very different products. Aiming to take on the provider operations in their entirety, HST has a PM system, billing, and scheduling systems. Turquoise covers everything to do with contracts. HST also has a more explicit consulting component as part of its customer support, whereas Turquoise Health's consulting-like features are embedded in its software tools and data insights. Further, Turquoise Health has a broad market across healthcare entities where HST caters only to ASCs. 

Ratings

 HST Pathways’ 7 reviews render an average rating of 4.5 / 5 stars on G2.

A Turquoise Health competitor with its own price engine

Healthcare BlueBook

Description

Like Turquoise, BlueBook has a comprehensive quality-cost dataset of American healthcare providers. Their Fair Price estimates are based on real claims data from thousands of shoppable procedures. Primarily serving employers, brokers, consultants, TPAs, and providers, its solutions aim to help employees navigate to the best provider and facility so they receive the highest quality care while saving money. It claims to save employers $1500 per employee per year. 

Healthcare Bluebook's quality and cost dataset stands out as a unique and powerful tool in the healthcare industry. Touted as the industry's largest of its kind, this comprehensive dataset covers a wide range of medical services and procedures, drawing from objective quality and price data sources rather than relying on self-reported information. 

What sets Bluebook Health apart is its integration of claims-driven ROI reporting, a feature that provides valuable insights for employers and payers. The dataset's side-by-side presentation of cost and quality ratings, particularly for inpatient procedures, enables users to easily identify high-quality, low-cost options. Bluebook's quality ratings are based on actual patient outcomes, including metrics such as unexpected readmissions, complications, safety events, and mortalities, rather than subjective assessments. These combined features bring comprehensive, objective, and actionable insights to healthcare consumers, employers, and payers alike.

Bluebook offers several key solutions:

• CareConnect: This service provides members with a personal concierge who guides them through complex, high-cost procedures, helping to identify and schedule care with high-value physicians and facilities within their insurance network.
• Comply: A compliance solution designed to help TPAs and health plans meet deadlines for the Transparency in Coverage rules and No Surprises Act, while also providing access to Bluebook's navigation solution.
• Provider Directory: Allows members and prospective members to search through available networks and determine if a provider or service is available within the network, enabling informed choices about healthcare providers[3].
• Plan Design+: Integrates incentives directly into medical plans rather than layering them on top as cash-based rewards, aiming to increase efficiency, member engagement, and savings.
• Quantros data analytics: Following the acquisition of Quantros' quality division, Bluebook now offers enhanced analytics capabilities leveraging a comprehensive dataset of healthcare quality and cost information.

Similarities between Turquoise Health and Bluebook Health

The primary commonalities between Turquoise Health's solutions and those of Healthcare Bluebook include:

• Price transparency tools: Both companies offer platforms that provide access to healthcare pricing information, allowing users to compare costs for various medical procedures and services.
• Quality information: Both provide quality information to help users make informed decisions.
• Data analytics: Both companies offer data analytics capabilities, leveraging large datasets of healthcare pricing and quality information.
• Compliance solutions: Both Turquoise Health and Healthcare Bluebook offer tools to help healthcare organizations comply with price transparency regulations and the No Surprises Act.
• Mobile accessibility: Both companies provide mobile applications or web-based platforms for easy access to their services.

Differences between Turquoise Health and Bluebook Health

While Bluebook Health has stayed focused on price and quality transparency, Turquoise Health has expanded into RCM solutions like contract management and modeling, patient payment estimates, and standard service package creation. These services reveal that Turquoise Health targets providers and payers more than the employers Bluebook pursues. Turquoise aims to improve revenue cycle management and operations, where Bluebook’s goal is to provide a convenient care search tool for patients and healthcare cost control for employers. 

Ratings

Bluebook Health has no reviews on G2, Capterra or other sites at this time.

A Turquoise Health alternative that targets service providers

Rivet Health

Description

Rivet Health is a healthcare revenue cycle management (RCM) software company founded in 2018 and based in Salt Lake City, Utah. Its platform accelerates revenue for healthcare providers, focusing on three key areas: patient pricing, payer performance, and claim resolution. 

Rivet's solutions include tools for generating automated and compliant patient cost estimates, managing payer contracts, detecting underpayments, and streamlining denials management. They strive to simplify RCM processes, enhance productivity, and maximize revenue for various healthcare organizations, including practices, hospitals, and medical billing companies. 

Their solutions are: 

• Revenue Diagnostics: Offers real-time insights into financial health, including revenue projection, cash flow, and claim adjudication through dashboards. Healthcare organizations use it to make data-driven decisions and pursue strategic growth opportunities.
• Patient Pricing: Generates accurate, NSA-compliant patient cost estimates by automatically verifying benefits and calculating contracted rates. This automation streamlines the financial clearance process and improves patient experience.
• Payer Performance: Provides a comprehensive suite for payer contract management, including payment variance detection, contract optimization, fee schedule simulations, and payer rate comparisons.  
• Claim Resolution: Streamlines the claims resolution process with customizable worklists, batch workflows, and personalized denial processing documentation. Healthcare staff use it to handle denials and recover revenue.

Similarities between Turquoise Health and Rivet Health

Turquoise Health and Rivet Health share several key similarities in their approach to healthcare technology solutions. 

Both companies emphasize healthcare price transparency, offering tools to help organizations comply with regulations and provide clear cost information to patients (good faith estimates). They each provide revenue cycle management tools and data analytics capabilities, enabling healthcare organizations to optimize their financial performance and operations.

As point solutions that target similar markets, both companies serve healthcare providers, payers, and other healthcare organizations. Their platforms are designed to integrate with existing healthcare IT systems, such as EHRs. Ultimately, both companies aim to reduce the administrative burden on healthcare organizations by streamlining processes and automating complex tasks.

Differences between Turquoise Health and Rivet Health

While the two companies' solutions overlap in some areas, key differences exist between them. 

• Primary and initial products: Turquoise Health prioritizes its price transparency database and solutions. Rivet Health provides tools for payer contract management, claim denial management, and automated patient payment estimate workflows.
• Target market: Turquoise Health serves a broader range of customers, including, payers, employers, consultants, health tech companies, and pharmaceutical firms. Rivet Health’s clients tend to be primarily healthcare providers and medical practices.
• Data sources: Turquoise Health leverages price transparency data from hospitals and insurers to power its platform. Rivet Health's data sources are payer contracts and provider EHR and PM systems. 

Rivet Health has earned an average 4.1 / 9 on Capterra and 4.1 / 9 on GetApp. 

A Turquoise Health competitor focused closely on contracts

PayrHealth

Description

PayrHealth offers end-to-end revenue cycle management (RCM) services designed to optimize financial performance for healthcare providers. Their RCM team focuses on winning correct revenue capture from misfiled, denied, or lost claims, ultimately boosting the bottom line for practices and health systems.

The company's RCM services are integrated with its contract negotiation and credentialing offerings, providing a comprehensive approach to healthcare financial management. By leveraging its expertise and partnerships with major payors, PayrHealth aims to resolve issues efficiently, secure competitive contracts, and identify new areas for revenue growth while reducing unnecessary spending. This comprehensive strategy gives healthcare providers an optimal view of their revenue stream and positions them for long-term financial success.

PayrHealth serves these markets within the healthcare industry:

• Hospitals and health systems
• Physician groups
• Ancillary providers (e.g., imaging centers, labs, and outpatient facilities)
• Private equity firms investing in healthcare

Its solutions are: 

• Payer Management: End-to-end solutions that cover all aspects of the payer-provider relationship, from contract negotiations to ongoing management. This service aims to optimize revenue, decrease leakage, and secure competitive payor contracts for healthcare providers.
• Payer Contracting: PayrHealth's expert team negotiates favorable contracts with payors to maximize reimbursement rates and minimize administrative burdens. They handle contract negotiations, renegotiations, and ongoing management to ensure providers receive the best possible terms.
• Revenue Cycle Management:  Comprehensive RCM services to streamline billing and collections, reduce denials, and accelerate payment cycles. This approach focuses on optimizing the revenue cycle by identifying risks, implementing structural improvements, and utilizing data analytics to enhance efficiencies.
• Physician Credentialing: Timely and accurate credentialing of providers, reducing delays and maintaining compliance with regulatory requirements. They manage the entire process, from application submission to primary source verification.
• Practice Marketing: PayrHealth helps healthcare practices craft and implement powerful marketing strategies to drive patient growth and visibility. Services include website development, targeted online advertising, SEO strategies, and reputation management to attract more patients and establish trust in the community.

Differences between PayrHealth and Turquoise Health

Where PayrHealth provides complete payer management services, including contract negotiations and market analysis, Turquoise Health’s central product is its price transparency engine. Turquoise Health expanded into contract management only after it promoted its pricing engine to patients, payers, providers, and even biotech companies. 

Other significant differences relate to the two companies’ business models. PayrHealth offers both software and legal, marketing, and RCM staff to help clients get important tasks completed in their revenue cycle. Payr’s staff provides the expertise to put clients on the right track in payer contract negotiations and more. Turquoise Health, on the other hand, is an online platform that leverages software to educate patients on provider prices and quality so they can make informed choices. Employers offering the Turquoise platform to their employees find they save $1500 per employee via improved healthcare costs. 

Similarities between PayrHealth and Turquoise Health

Despite the above differences, PayrHealth and Turquoise Health share some important aspects.

Both companies offer solutions aimed at improving financial processes in healthcare, with a particular focus on enhancing price transparency in alignment with recent regulatory requirements. They both provide tools for managing payer contracts, although Turquoise Health's approach is more technology-driven. 

Compliance support is another shared feature, with both companies offering solutions to help healthcare organizations meet price transparency regulations. Lastly, both PayrHealth and Turquoise Health employ a data-driven approach, leveraging analytics to provide insights and improve decision-making for their clients.

Ratings

PayrHealth has no reviews on G2, Capterra or others at this time. 

How MD Clarity’s contract management & modeling solution optimizes your revenue

Turquoise Health and its competitors are helping healthcare providers and patients enjoy transparent, affordable, and convenient care. The RCM partner you choose will depend on your organization’s unique challenges and opportunities. 

MD Clarity's RevFind is an automated contract management solution that streamlines the entire contract lifecycle. It offers contract templates, evaluates payer performance, and sets up renewal alerts. By digitizing and centralizing agreements, RevFind enables easy comparison of reimbursements across various parameters.

The system meticulously compares each payer payment to contract terms, generating reports that allow staff to quickly appeal improper reimbursements. RevFind incorporates Medicare benchmarks for additional performance evaluation and provides detailed analytics to identify favorable and unfavorable payers, enhancing negotiation leverage.

RevFind's automated alerts for contract milestones ensure timely negotiations, with customizable notifications available 90 days in advance. By generating automated reports and identifying systemic underpayment causes, RevFind empowers healthcare providers to address current pricing discrepancies and prevent future underpayments, maximizing revenue and maintaining fair pricing.

Schedule a demo to see how RevFind helps you understand and strengthen your contracts, limit your underpayments and denials, and model proposed rate changes.  

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