Who We Serve - Research

Overview

FAIR Health is privileged to have its data serve as the foundation for research studies on all aspects of the healthcare delivery system. In keeping with our mission as a nonprofit organization dedicated to transparency in healthcare costs and health insurance information, we make our data repository of billions of private healthcare claim records—the largest such collection in the nation—available to academics, government agencies, policy makers, clinical researchers, commercial R&D analysts, think tanks and others advancing critical healthcare research. Our independence and neutrality make FAIR Health a natural ally to researchers seeking unbiased data to support public health, policy making and healthcare research.

As a prudent and trusted steward of data, we make our data available to both funded researchers and those in need of in-kind support. In addition to providing aggregated, de-identified datasets to researchers, we offer flexible collaboration on all project facets and share our expertise on claims and healthcare issues by providing custom analyses or compilations of de-identified data. FAIR Health also is assisted by an Academic Advisory Board that provides valuable guidance to internal and external data initiatives as we advance our mission to contribute to public knowledge.

How We Can Help

Third-Party-Funded Research

FAIR Health makes data and analytics available to researchers for studies on the full range of topics supported by our repository.

For researchers with third-party funding looking for data resources, FAIR Health offers a broad array of services tailored to the researcher’s particular needs. These might include:

Assisting with framing study questions;
Assessing whether FAIR Health data resources are responsive to the inquiry (e.g., performing diagnostics to determine whether the requisite volume of data is available to support the study);
Providing assistance in estimating budgets for required data resources;
Refining study design and providing analytic support;
Generating de-identified, aggregated datasets;
Populating data tables and developing other data visualizations; and
Reviewing prepublication drafts to ensure data are represented accurately.

We do not limit or opine on researchers’ topics or theses. Our licensing fees are compatible with most research budgets, with pricing at cost.

In-Kind Support

For those without third-party funding, FAIR Health can often provide data and other in-kind support. Although in-kind support is subject to available resources, demand and data use policies, we provide many of the same services that we offer to third-party-funded research projects, including assistance with framing inquiries, diagnostics, aggregated datasets and data visualizations, among others.

Given the recent national focus on healthcare inequities, FAIR Health will prioritize supporting projects that profile underserved communities and explore disparities in healthcare quality and outcomes.

De-Identified, Aggregated Datasets

Based on researchers’ specifications, FAIR Health can extract custom datasets that can include elements such as de-identified member IDs trackable over time, patients’ age and gender distribution, ICD-9 and ICD-10 procedure codes, geographic locations, professionals’ specialties and more. Our data can inform a broad spectrum of studies, such as:

Identifying trends in utilization and cost across places of service;
Using de-identified member data to track patients’ beginning-to-end treatment paths;
Tracking trends in diagnoses over time;
Illustrating a hypothesis with the support of real-world data;
Conducting population health analyses;
Studying current issues affecting the national healthcare system; and
Assessing the intended and unintended influence of laws and regulations.

Using our state-of-the-art technology, FAIR Health also can provide analytics customized to researchers’ particular needs.

Health White Papers and Data Briefs

In addition to making data available to researchers, FAIR Health produces its own independent white papers and briefs on various topics of national interest and public health concern. These widely disseminated publications cover critical public policy topics such as COVID-19, the opioid crisis, Lyme disease and food allergy, as well as annual reports on place of service trends and medical pricing.

Included in our white papers and briefs are a number of data visualizations and statistics that researchers are permitted to cite as references to support their own studies. For a sampling of how such data have already been incorporated in researchers’ publications, click here.

FH® Benchmarks

FH Benchmarks are relied upon by clients nationwide, including researchers who incorporate our benchmark data into their studies and publications.

FAIR Health uses the private claims data in our repository to generate cost benchmarks by procedure code and percentile (50th‐95th percentiles, although lower percentiles are available upon request), reflecting the distribution of billed charges and estimated allowed amounts for medical and dental services and procedures across all 50 states; Washington, DC; Puerto Rico; and the US Virgin Islands.

A suite of self-contained modules organized by service type, FH Benchmarks aggregate claim records from our database by official healthcare code (e.g., CPT®¹ and CDT®²) and geozip (geographic area usually determined by the first three digits of a zip code), and array benchmarks for each procedure/geozip combination into percentiles.

For more information on FAIR Health benchmark data products, click here.

¹ CPT © 2019 American Medical Association (AMA). All rights reserved.
² The Code on Dental Procedures and Nomenclature is published in Current Dental Terminology (CDT), American Dental Association (ADA). All rights reserved.

FH® Explore

FH Explore is another data resource useful to researchers. A FAIR Health-hosted data enclave, FH Explore provides web-based access to an expanded range of data without exposing the underlying data to external environments. This solution creates a balanced approach to protecting FAIR Health’s data while serving as a flexible data access platform. FH Explore uses de-identified aggregated data views, providing robust data visualizations and other analytic tools.

FH explore currently offers users access to detailed datasets focused on telehealth. Additional later datasets will address other venues of care, patient cohorts and provider specialties, including datasets focused on testing, treatment and comorbidities associated with COVID-19. FH Explore allows for specified mining of one or multiple datasets. The tool features an integrated interface that enables users to save searches and download data tables and aggregated data. Users also have the ability to create visualizations such as graphs, pie charts and maps.

For more details on FH Explore, click here.

New York University (NYU) Capstone Project

FAIR Health has been selected to participate as a “client” in the capstone program for NYU Robert F. Wagner Graduate School of Public Service. Completing a capstone project is part of NYU Wagner’s core curriculum and provides students with a critical learning experience and opportunity to perform a public service. FAIR Health is working with a small team of students within the school for a full academic year. The capstone team will generate actionable findings to help inform policies and clinical guidelines in response to the COVID-19 pandemic. This analysis will not only build upon FAIR Health’s previous studies, but also will help to directly inform public health responses and decision making based on patient outcomes data. The final report from the capstone team could help serve as the basis for guidelines and recommendations for treatments, vaccination distribution and clinical practices in management and testing.

Data Assets

FAIR Health Private Claims Repository

FAIR Health’s database of private healthcare claims information—the largest in the nation—currently contains more than 32 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. FAIR Health data are submitted by over 60 national and regional payors and third-party administrators (TPAs) who insure or process claims for private insurance plans (both fully insured and self-insured plans), covering more than 150 million individuals. FAIR Health data are statistically significant for all 50 states and the District of Columbia.

Over 100 million covered lives in the current year in the repository are trackable longitudinally, allowing for a valuable window into provider performance, treatment outcomes and patient migratory patterns, among other studies.

FAIR Health collects most data fields reported on medical and dental claims, including diagnoses, procedures, venues of care (e.g., urgent care center, hospital, telehealth, retail clinic, physician’s office, home care), provider specialties and geographic location of services, among others.

Certified CMS Qualified Entity

Recognizing FAIR Health’s ability to securely house and effectively use our industry-leading repository of privately billed claims data to bring value to the healthcare sector, the Centers for Medicare & Medicaid Services (CMS) has certified FAIR Health as a Qualified Entity (QE). With this certification, FAIR Health has been entrusted with the complete collection of Medicare Parts A, B and D claims for all individuals across the country enrolled in traditional Medicare from 2013 to the present—a collection of over 33 billion claim records. (Data on Medicare Advantage enrollees is included in the private claims database.)

FAIR Health uses QE data, combined with data from our vast private claims repository, to create public reports which are freely available on our consumer website, and for other authorized purposes. FAIR Health can collaborate with qualified researchers, applying jointly to CMS for permission to reuse the Medicare data in research studies. Because FAIR Health has already demonstrated to CMS our technological and professional capability for managing and securing vast, sensitive data collections, and because CMS imposes significantly reduced administrative fees for data reuse, researchers may find it both efficient and cost-effective to collaborate with FAIR Health in order to study Medicare data.

FAIR Health Neutrality

FAIR Health is regarded as a fair and neutral provider of robust data and data tools by diverse stakeholders throughout the healthcare sector. Our data have been incorporated in statutes and regulations around the country and designated as an official, neutral data source for official federal reports and initiatives as well as for a variety of state health programs and in various state laws and regulations. Unbiased and conflict-free, FAIR Health licenses data products directly to more than 1,500 organizations nationwide, including state and federal agencies, health plans, insurers, TPAs, employers, unions, provider networks, healthcare professionals, academics, policy makers and researchers.

Interacting with all healthcare stakeholders enriches our work and helps inform our objective data benchmarks and custom analytics, which support sound decision making throughout the healthcare marketplace. As a nonpartisan not-for-profit that qualifies as a public charity under section 501(c)(3) of the tax code, we work to bring transparency, integrity, reliability and accessibility to healthcare information for all healthcare stakeholders.

Contact Us

To learn more, 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.

Any engagement with a researcher would be memorialized in a Standard Data Use Agreement that incorporates the Statement of Work (including a description of licensed data resources and/or analytic support and the scope of the project) and terms of use.