FAIR Health Research

FAIR Health publishes original data studies exploring healthcare-related issues. Not surprisingly, most of this year’s studies concerned the COVID-19 pandemic, including five data briefs and a white paper. In addition, we created the Monthly Telehealth Regional Tracker and other resources focused on telehealth. We also released our annual report on place of service trends and medical pricing, as well as infographics on sexually transmitted diseases and FAIR Health consumer website usage statistics.

FAIR Health, Cost Information Enhances Shared Decision Making: Lessons from FAIR Health’s Shared Decision-Making Initiative, A FAIR Health Brief, December 10, 2020.
This brief presented lessons learned from FAIR Health’s shared decision-making initiative combining cost and clinical information for patients and caregivers facing palliative care situations. Presented on our free, award-winning consumer website, fairhealthconsumer.org, the three palliative care scenarios were: (i) staying on or stopping kidney dialysis for end-stage renal disease, (ii) pursuing different nutrition options when swallowing is difficult and (iii) staying on or removing a breathing machine. Among the lessons learned: Conversations surrounding cost in palliative care enhance decision making.

FAIR Health, Risk Factors for COVID-19 Mortality among Privately Insured Patients: A Claims Data Analysis, A FAIR Health White Paper in Collaboration with the West Health Institute and Marty Makary, MD, MPH, from Johns Hopkins University School of Medicine, November 11, 2020.
This white paper analyzed risk factors for COVID-19 mortality—including age, gender and preexisting comorbidities—among privately insured patients. Drawing on the de-identified longitudinal dataset of the FAIR Health National Private Insurance Claims (FH NPIC®) repository, the white paper included as its study population 467,773 patients diagnosed with COVID-19 from April 1, 2020, through August 31, 2020. Among other findings, the study revealed that, across all age groups, the top three comorbidity risk factors for death from COVID-19 were, in order from highest to lowest risk, developmental disorders, lung cancer, and intellectual disabilities and related conditions. The results of this analysis may help inform protocols for vaccine distribution as well as prevention and treatment protocols.

FAIR Health, Dental Services and the Impact of COVID-19: An Analysis of Private Claims, A FAIR Health Brief, September 16, 2020.
Studying the impact of COVID-19 on dental service utilization, this fifth COVID-19 brief compared such utilization in the first six months of 2020 to the first six months of 2019, with special emphasis on March and April 2020, when the pandemic was rampant and many dental practices were closed, and June 2020, when many dental practices had reopened. The analysis was striated by age, state and procedure code, as well as by dental-related diagnoses in urgent care centers and emergency rooms. The study showed that use of privately insured dental services fell 75 percent in March 2020 and 79 percent in April 2020 compared to the same months the year before.

FAIR Health, Key Characteristics of COVID-19 Patients: Profiles Based on Analysis of Private Healthcare Claims, A FAIR Health Brief, July 14, 2020.
Using data from the period January-May 2020, this fourth COVID-19 study illuminated some of the key characteristics of patients diagnosed with COVID-19. These characteristics included age, gender, rural versus urban area by age, venue of care where first diagnosed, venue of care by age, comorbidities of hospitalized patients and median costs of hospitalization. The patient characteristics were analyzed nationally and by US census region. The findings included: Nationally and in every region, chronic kidney disease and kidney failure were the most common comorbidity in hospitalized COVID-19 patients, accounting for 13 percent of all such patients.

FAIR Health, Healthcare Professionals and the Impact of COVID-19: A Comparative Study of Revenue and Utilization, A FAIR Health Brief, June 10, 2020.
This third COVID-19 study analyzed the impact of the COVID-19 pandemic on healthcare professionals’ utilization and revenue based on estimated allowed amounts in the first four months of 2020 as compared to 2019. The brief focused on seven specialties: cardiology, dermatology, oral surgery, gastroenterology, orthopedics, pediatric primary care and adult primary care. Changes in the five most common procedures for each specialty in the first four months of 2020 were also studied. The report found that in April 2020, healthcare professional services declined 68 percent in utilization and 48 percent in revenue based on total estimated allowed amounts compared to April 2019 nationally.

FAIR Health, Illuminating the Impact of COVID-19 on Hospitals and Health Systems: A Comparative Study of Revenue and Utilization, A FAIR Health Brief, May 12, 2020.
This second COVID-19 study examined the impact of COVID-19 on hospitals and health systems by comparing private insurance claims from the first quarters of 2020 and 2019, focusing on the effects in March 2020 on estimated allowed amounts and patient discharge volume. The brief also analyzed differences between the Northeast, the region hit hardest by the pandemic at the time, and the nation as a whole. The first quarter was analyzed month by month, and March week by week. Additionally, settings (inpatient, outpatient, emergency room) and diagnoses and procedures were examined. Among the findings: In the third week of March 2020, as the COVID-19 pandemic escalated, large hospitals in the Northeast experienced a 26 percent decline in average per-facility revenues based on estimated allowed amounts as compared to the same period in 2019.

FAIR Health, COVID-19: The Projected Economic Impact of the COVID-19 Pandemic on the US Healthcare System, A FAIR Health Brief, March 25, 2020.
This first COVID-19 study projected US costs for COVID-19 patients requiring inpatient stays. The costs of COVID-19 medical care, including charges and estimated allowed amounts, were estimated based on proxy codes used by providers, on the basis of inpatient ICD-10 procedure codes and revenue codes (IIR) as well as diagnosis-related groups (DRGs). The brief also examined telehealth codes commonly used for respiratory infections and their costs. On the basis of IIR, the study estimated the total average charge per COVID-19 patient requiring an inpatient stay at $73,300 and the total average estimated allowed amount per commercially insured patient at $38,221.

FAIR Health, FH® Healthcare Indicators and FH® Medical Price Index 2020: An Annual View of Place of Service Trends and Medical Pricing, A FAIR Health White Paper, March 2020.
This was the third edition of FAIR Health’s annual white paper on place of service trends and medical prices, developed to assist the full spectrum of healthcare stakeholders by providing clarity in a rapidly changing healthcare environment. The FH Healthcare Indicators focused on alternative places of service—retail clinics, urgent care centers, telehealth and ambulatory surgery centers (ASCs)—and compared them to the more traditional venues of emergency rooms (ERs) and offices, with an emphasis on changes in utilization, geographic and demographic factors, diagnoses, procedures and pricing. The report showed that, from 2017 to 2018, use of telehealth and retail clinics grew, but use of urgent care centers, ASCs and ERs declined. The FH Medical Price Index presented an overview from May 2012 to November 2019 of the weighted average growth in median billed charges and median allowed amounts in six procedure categories: professional evaluation and management (E&M), hospital E&M, medicine, surgery, pathology and laboratory, and radiology.

FAIR Health, Sexually Transmitted Diseases (STDs): A Growing Health Problem, A FAIR Health Infographic, February 2020.
This infographic compared national, urban and rural increases in claim lines with STDs as a percentage of all medical claim lines from 2007 to 2018. It documented the specific STD diagnoses with the greatest percent increase in claim lines during that period and studied various STD diagnoses by age and gender. Among the findings: Claim lines with STD diagnoses, as a percentage of all medical claim lines, increased nationally 76 percent from 2007 to 2018.

FAIR Health, Fairhealthconsumer.org Usage Statistics, A FAIR Health Infographic, January 2020.
This annual infographic displayed year-end statistics on usage of FAIR Health’s free, award-winning, healthcare cost transparency website for consumers, fairhealthconsumer.org. The infographic included users’ age, gender, top 10 states of origin, insurance status, interests and most frequently visited resources. The statistics showed that, for the second year in a row, “MRI” was the top searched medical term and “root canal” the top searched dental term.

Telehealth Resources
In 2020, the COVID-19 pandemic made telehealth more relevant than ever, as patients and providers nationwide turned to this venue of care for reduced risk of disease transmission. FAIR Health delved into the changing profile of telehealth with three new resources:

  • Monthly Telehealth Regional Tracker. Launched in May as a free service, the Monthly Telehealth Regional Tracker uses FAIR Health data to track how telehealth is evolving from month to month. An interactive map of the four US census regions allows the user to view an infographic on telehealth in a specific month in the nation as a whole or in individual regions. Comparing 2020 to 2019, the Tracker presents data on the volume of claim lines, urban versus rural usage, diagnoses and procedure codes. Among its findings: Telehealth claim lines increased 4,347 percent nationally from March 2019 to March 2020.
  • FH® Telehealth. This addition to FAIR Health’s suite of FH® Benchmarks provides charge benchmarks for services conducted via telehealth. FH Telehealth is a means for understanding in greater depth the distinct pricing associated with medical services provided via video, telephone or other electronic means.
  • FH® Explore. FH Explore is a flexible resource designed for customized views into healthcare data. A FAIR Health-hosted data enclave using de-identified, aggregated data views, FH Explore provides web-based access to a range of data fields focused on telehealth.