FAIR Health Data Repository Approaches 36 Billion Private Claim Records
January 20, 2022
Already the largest repository of private healthcare claims in the nation, the FAIR Health data repository is now approaching the threshold of 36 billion claim records. Growing at a rate of more than two billion claim records a year, the repository is the foundation for all that we do with our data, from standard benchmarks to custom analytics, consumer resources, support for government programs, research studies, and more.
Known as the FAIR Health National Private Insurance Claims (FH NPIC®) database, the repository contains claims from 2002 to the present, with new claims received each month. The 70-plus payors and administrators who submit the data insure or process claims for both fully insured and self-insured plans, covering individuals located in 493 geozip regions across all 50 states; Washington, DC; Puerto Rico; and the US Virgin Islands. Geozips tend to track with the first three digits of a zip code, although FAIR Health can also configure data into state values, rural/urban clusters, census regions and/or medical service areas.
Benchmark Modules
The continuing increase in the volume of claims in FH NPIC allows us to serve healthcare stakeholders in many ways. With those data, we have been able to expand and enrich our suite of charge and allowed benchmark modules and other industry-standard claims data resources. For example, we recently launched two new allowed modules, FH® Allowed Telehealth and FH® Allowed Inpatient Facility ICD Proc/Rev, as well as FH® NSA Reference File, a resource to support the federal No Surprises Act (NSA).
Custom Analytics
The data in FH NPIC power a broad range of custom analytics, designed to meet the specifications of particular clients. Because FH NPIC includes a subset of longitudinal data, custom analytics can include the tracking of individual de-identified patients over time. A hospital or health system, for example, can study outmigration and referral patterns in its geographic area. An insurer can use custom analytics to help inform provider network and benefit design. One common type of custom analytic is a custom benchmark, which permits study of a selected range of procedure codes (e.g., behavioral health or orthopedic codes), or of percentiles and regions not typically offered in our standard benchmark modules.
Consumer Resources
FH NPIC also fuels the medical, dental and shoppable services cost lookup tools on our free, award-winning consumer website. Available in English (fairhealthconsumer.org) and Spanish (fairhealthconsumidor.org), the website allows consumers to look up typical costs for healthcare procedures in their own geographic areas and adjacent areas. The costs are put in context with a rich, original educational curriculum about health insurance, including articles, videos, resource links, a healthcare quality toolkit and a glossary. The website also contains shared decision-making tools that offer decision aids with clinical and cost information.
Government Programs
As a testament to the reliability and objectivity of FAIR Health data, the data in FH NPIC have been incorporated into statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers’ compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of state surprise billing laws in Connecticut, Georgia, New Mexico, New York and Texas.
Research Studies
FAIR Health data likewise serve as the foundation for varied research studies. For example, we have analyzed FH NPIC data in white papers and briefs on the COVID-19 pandemic, air ambulance services, the opioid crisis, pediatric obesity and type 2 diabetes, food allergy, behavioral health, and place of service trends and medical pricing. External researchers have cited our data and our data studies in studies of their own, in journals such as JAMA, Health Affairs and Pediatrics, and in government reports such as those by the Government Accountability Office (GAO) and the Medicare Payment Advisory Commission (MedPAC).
For more information on FAIR Health’s repository of private claims and its uses, contact us by email at info@fairhealth.org or call us at 855-301-FAIR (3247), Monday through Friday, 9 am to 6 pm ET.