Faster Innovation. Deeper Data. Smarter Insights.

At Deerhold, innovation moves quickly. With the PRIZM platform, powered by Deerhold, there’s no traditional 6–12 month roadmap—our monthly sprint cycle ensures that client feedback and market needs are rapidly translated into meaningful platform enhancements.

PRIZM Version 4.8, alongside the Q1 2026 data refresh, delivers powerful new capabilities for brokers, stop-loss carriers, MGUs, and healthcare providers—enhancing data coverage, improving pricing accuracy, and expanding analytical flexibility.

Q1 2026 Data Enhancements

Enhanced Standardization for More Comprehensive Analysis

PRIZM Version 4.8 builds on Deerhold’s long-standing expertise in standardizing healthcare price transparency data. This release further refines our standardization logic to capture additional outlier and edge-case scenarios within reimbursement methodologies already supported by the platform. These refinements enable Deerhold clients to perform more reliable and comprehensive pricing analyses across networks and payers.

Key Benefits

• Apples-to-apples comparisons across reimbursement types

• Expanded analytical coverage for complex contract structures and pricing structures

• Greater confidence in pricing insights and benchmarking

Custom Record Support - Improved Data Coverage for Medicare Comparisons
Payers often include custom “catch-all” codes in their machine-readable files (MRFs). PRIZM now identifies and incorporates these records, significantly expanding usable data and improving percentage-of-Medicare calculations.

What this means for Deerhold clients:

• Broader rate coverage across services

• More accurate Medicare benchmarking

• Enhanced visibility into payer contracting strategies
  

Enhanced Support for DRG-Based Pricing

PRIZM has long supported Medicare Severity Diagnosis Related Groups (MS-DRGs). Version 4.8 introduces additional enrichment to better capture real-world contracting scenarios and improve pricing analysis for specific payers and edge case scenarios.

New Capabilities (See Glossary for additional detail)

• Per Diem MS-DRG Analysis: Rates reported as per diems are now aligned with comparable Medicare benchmarks.

• Bundled MS-DRG Network Analysis: Network analyses run through PRIZM Networks now include rates for service bundles for those payers that categorize MS-DRGs as bundled payment arrangements.

• APR-DRG Rate Support: Contracted rates based on All Patient Refined Diagnosis Related Groups (APR-DRGs) are now surfaced within PRIZM Rates, with expanded platform support planned for future releases.

What this means for Deerhold clients:

• More complete representation of inpatient reimbursement models

• Improved benchmarking across complex payment structures

• Deeper insight into payer-provider contracting dynamics

Improved Data Quality Through Outlier Rate Removal

PRIZM Version 4.8 introduces enhanced filtering to identify and remove unrealistic rate records for specific TIN and billing code combinations. This results in cleaner datasets and more reliable analytics.

What this means for Deerhold clients:

• Higher data accuracy 

• Reduced noise in pricing analyses

• More dependable benchmarking results

Carrier and Network Updates

To ensure alignment with how various health plan networks are recognized in the industry, several carrier-specific updates have been implemented. For example, we’ve adjusted network names to ensure networks are represented by their externally marketed names as opposed to their internal codes. We’ve also added a new payer to the platform.

What this means for Deerhold clients:

• Improved network identification and searchability

• More accurate market analyses
  
  

Product Enhancements

PRIZM Release Version 4.8 introduces several new product features, including a new Histogram Chart, a centralized Visualization menu, and enhanced Hospital Lookup and User Settings.

New Histogram Visualization

A powerful new Histogram Chart has been added to the Visualizations module within the PRIZM platform. This chart enables Deerhold clients to quickly understand the distribution of provider reimbursement levels relative to Medicare.

What this means for Deerhold clients:

• Faster insight into network competitiveness

• Improved decision-making for contracting and negotiations

• Enhanced visual storytelling for client presentations

• Rapid identification of pricing outliers and market positioning
  

Centralized Visualization Menu

All visualization reports, including the new Histogram Chart, are now grouped under a dedicated Visualization menu in the navigation bar, improving usability and streamlining access to analytical tools.

Hospital Lookup Enhancements 

Added Address and DBA Name fields to simplify hospital identification and searching.

User Settings Improvements

Users can now set default Fields and Filters when querying Hospital MRF data. Default selections can be easily applied or removed by selecting or deselecting the “Default” button.

What this means for Deerhold clients:

• Increased workflow efficiency

• Personalized user experience

• Faster access to relevant hospital price transparency data
  
  

Why This Release Matters

PRIZM Version 4.8 reinforces Deerhold’s leadership in healthcare price transparency by combining rapid innovation with deep data expertise. Rather than simply aggregating data, Deerhold transforms complex and inconsistent pricing information into standardized, actionable insights.

Key Advantages for Prospective Clients

• Rapid innovation: Enhancements delivered through a monthly sprint cycle

• Comprehensive data coverage: Inclusion of custom codes and complex reimbursement models

• High data quality: Advanced standardization and outlier filtering

• Actionable analytics: Intuitive visualizations and improved benchmarking capabilities

• Market-aligned insights: Accurate representation of payer networks and contracts
  
  

Glossary

MS-DRG Per Diem Rates

Medicare Severity Diagnosis Related Group (MS-DRG) payments are typically fixed per-discharge amounts but may be reported or negotiated as per diem rates for certain billing scenarios or specialized care settings. PRIZM standardizes these variations for consistent comparison.

APR-DRG

All Patient Refined Diagnosis Related Groups (APR-DRGs) expand upon MS-DRGs by incorporating severity of illness and risk of mortality, enabling more granular reimbursement structures.

Custom Codes (CSTM)

CSTM values are payer-defined identifiers used as “catch-all” rate records in machine-readable files (MRFs). Payers can use CSTM values when a standard billing code—such as CPT, HCPCS, ICD, or DRG—does not adequately represent the contracted reimbursement arrangement. 

The Centers for Medicare and Medicaid Services (CMS) introduced CSTM values as part of the technical implementation guidance for the Transparency in Coverage Final Rule (TiC Final Rule). PRIZM identifies and incorporates these codes to enhance data coverage and Medicare benchmarking and comparisons.