The FAIR Health Role in Research

FAIR Health is privileged to have its data serve as the foundation for research studies on all aspects of the healthcare delivery system. These studies include those developed by the FAIR Health team as well as those developed by external researchers.

At the heart of both the FAIR Health and external research is our FAIR Health National Private Insurance Claims (FH NPIC®) repository of private healthcare claims, the nation’s largest. At present, the database contains more than 30 billion claim records for medical and dental services from 2002 to the present and is growing by more than 2 billion new claim records per year. The data are submitted by over 60 national and regional payors and third-party administrators who insure or process claims for private insurance plans (both fully insured and self-insured plans), covering more than 150 million individuals located in 493 geozip regions across all 50 states; Washington, DC; Puerto Rico; and the US Virgin Islands. Approximately 65 million covered lives annually are trackable longitudinally in the repository.

As a public service, in keeping with our mission as a nonprofit organization dedicated to transparency in healthcare costs and health insurance information, we issue publications based on our data, such as white papers, briefs and infographics. In past years, we released a series of white papers on the opioid crisis, as well as stand-alone studies on pediatric obesity and type 2 diabetes and on food allergy. Our revealing infographics in past years covered topics ranging from Lyme disease, concussions and oral cancer to sleep apnea.

This year we continued that tradition. We released white papers on Lyme disease, behavioral health, telehealth, and place of service trends and medical pricing. We also issued a brief on surprise billing and twin infographics on usage of our consumer website in English (fairhealthconsumer.org) and Spanish (fairhealthconsumidor.org)—a site where consumers estimate medical and dental costs and learn to navigate the healthcare system. For more details, see the summary of this year’s FAIR Health Research in this issue.

External studies that use FAIR Health data are also part of our tradition. For years, academic researchers at major universities, as well as scholars and scientists in think tanks and government agencies, have cited FAIR Health data in studies of health policy, public health, medicine and law. This year alone, FAIR Health data were used by the United States Government Accountability Office in a study of air ambulance costs, and by the Massachusetts Health Policy Commission in a comparison of possible out-of-network provider payment benchmarks related to surprise billing. FAIR Health data were pivotal to studies of such subjects as utilization of fertility preservation services before hematopoietic cell transplantation, overutilization of computed tomography, cost savings attributable to point-of-care ultrasonography, and the effects of commercial dental insurance market concentration. For more details, see the summary of this year’s External Research in this issue.

In addition, FAIR Health has collaborated with other organizations to apply our data to research topics as diverse as cancer, organ donation, imaging practices and market consolidation. Media outlets for the general public and for healthcare sector professionals regularly report on FAIR Health and externally generated research.

For more information on using FAIR Health data and analytics for research, 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.