• What is fair health?

    Adam Searing has a piece in today’s Raleigh (N.C.) News and Observer describing Fair Health:

    …a national independent, not-for-profit corporation whose mission is to bring transparency to healthcare costs and health insurance information through comprehensive data products and consumer resources. FAIR Health uses its database of billions of billed medical and dental services to power a free website that enables consumers to estimate and plan their medical and dental expenditures….

    The non profit organization grew out of a 2009 investigation (and settlement) conducted by New York State Attorney General (now Governor) Andrew Cuomo.

    As part of the collective settlement the Attorney General’s office reached with the insurers, FAIR Health received millions of de-identified healthcare claims that many had used to help them determine their rates. This data continues to be analyzed and processed with the goal of increasing its completeness, accuracy, and neutrality, as it will form the basis of our licensed products. The data will also be the basis of educational products and tools for consumers made available on this website.

    I have not used the website as of yet, and it is not clear to me how broad its data collection reach may be (though Searing says N.C. insurers have submitted claims information). However, this looks like an interesting effort to monitor the cost of care, whose goal is to provide data to consumers on the cost of medical and dental care, particularly for persons who may be interested in seeking health care services from out of network providers.


    • FAIR Health isn’t exactly new, as it’s been around for roughly two years, and if I recall it first started presenting data to the public in early or mid-2011.

      Note that there are a lot of limitations to what it can provide at this time. The limitations aren’t so much in the volume of claims, but in the fact that FH doesn’t know your benefits. It doesn’t know your coinsurance, your OON deductible, your OOP maximum, etc. And I think only coinsurance can be manually entered into the tool currently. There are other limitations, such as that the tool looks at one CPT code at a time, and for inpatient and outpatient facility services that is pretty inadequate.

      If you are insured by a large health plan, there is a good chance you have a better tool available on your insurer’s website.

      • @Jonathan H
        I hadn’t heard of it. Thanks for your insight about the limitations of what it can do. I will ask Adam Searing about these limitations.