FAIR Health Data Repository Surpasses 38 Billion Private Healthcare Claim Records
October 20, 2022
In a significant milestone, FAIR Health’s private healthcare claims repository recently surpassed 38 billion claim records, spanning the period from 2002 to the present. Already the nation’s largest repository of private healthcare claims, the database is growing at a rate of more than two billion claim records a year. Separately, our repository of Medicare fee-for-service data, which we receive as a national, certified Qualified Entity from the Centers for Medicare & Medicaid Services, recently exceeded 41 billion claim records from 2013 to the present.
The FAIR Health data repository has grown because we are recognized as prudent stewards of the data that our contributors entrust to us and because of the increasing use of or reference to FAIR Health data in state and federal healthcare-related programs. The 70-plus payors and administrators who submit the private claims data to our repository insure or process claims for both fully insured and self-insured plans, covering individuals located in 493 regions across all 50 states; Washington, DC; Puerto Rico; and the US Virgin Islands.
States
The breadth of FAIR Health data has attracted, among others, an increasing number of states for a variety of official purposes. For example, numerous states rely on FAIR Health to help develop and update their workers’ compensation fee schedules; others use FAIR Health to support their personal injury protection (PIP) programs. (See the article in this issue entitled “Arizona and New Jersey Award Fee Schedule Engagements to FAIR Health.”) In Connecticut, Georgia, New Mexico, New York and Texas, FAIR Health data serve as the official data source for surprise billing laws. Other state uses for FAIR Health data include, but are not limited to, supporting multiple state crime victim funds and, in New York, supporting the medical indemnity fund for birth-related neurological injuries.
The data serve as the foundation for varied research studies undertaken by FAIR Health that are widely disseminated. For example, we have analyzed our data in white papers and briefs on the COVID-19 pandemic, telehealth, air and ground 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 articles published in journals such as JAMA, Health Affairs and Pediatrics, and in government reports such as those by the US Government Accountability Office (GAO) and the Medicare Payment Advisory Commission (MedPAC).
Healthcare Sector
Stakeholders across the healthcare sector rely on our data. With the continuing increase in the volume of claims in our data repository, we have been able to expand and enrich our suite of charge and allowed benchmark modules and other industry-standard claims data resources to meet varied stakeholder needs. Our data power a broad range of custom analytics, designed to meet the specifications of particular clients. Because our database of private healthcare claims 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, among other uses.
Consumer Resources
The FAIR Health data repository 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.
For more information on FAIR Health’s data repository and its uses, contact us by email at info@fairhealth.org or call us at 855-301-3247, Monday through Friday, 9 am to 6 pm ET.