Health Data for Action (HD4A), a signature research program of the Robert Wood Johnson Foundation (RWJF) administered by AcademyHealth, made access to big datasets available to researchers through competitive calls for proposals so they could use that data to answer important research questions and inform health policy -- questions that might otherwise go unstudied.
In this second installment of our five-part interview series, moderated by Kevin McAvey, managing director at Manatt Health, we explore how access to data was critical in investigating variations in health care prices.
Making data usable for researchers
Watch this interview to hear 2024 HD4A grantee Dr. Christopher Whaley, associate professor at Brown University, in conversation with Todd Gottula, co-founder and president of Clarify Health Solutions. They discuss the significance of price transparency in health care, particularly focusing on how data can expose the variation in health care prices. The goal of Dr. Whaley’s study is to document and describe health care price variation across procedures, providers, insurers, and markets using Clarify Health’s Transparency in Coverage data. In the interview, he describes how having access to the Transparency in Coverage data has allowed him to more thoroughly and accurately investigate why prices vary among providers and insurers. Gottula chronicles how Clarify Health takes the massive, and often incomplete and confusing Transparency in Coverage data, and makes it usable for researchers like Whaley.
What stood out and why it matters
- Health Care Price Variation: Health care prices can vary wildly, but these differences don’t always match the quality of care, how easy it is to get, or how well it works. This can be confusing and frustrating for people who need care and those who pay for it, because there’s often no clear reason why the prices are so different.
- Role of Insurers and Employers: Insurers and large employers play a crucial role in using data about health care pricing to negotiate better rates and design more efficient networks. This can drive down health care costs for consumers.
- Data Utilization: Transparency in Coverage data, aggregated through platforms like Clarify Health, offers comprehensive insights into health care pricing, allowing researchers to understand why prices vary and how market dynamics influence costs.
- Challenges with Data: There are significant challenges associated with using this data, such as dealing with "zombie rates" and ensuring accurate cross-referencing between different data sets. We need better tools to organize the data and make it easier to use.
- Policy Implications: The data can be used by policymakers, especially at the state level, to understand pricing structures within their jurisdictions and regulate unfair practices.
What surprised you?
It’s hard to grasp the scale and complexity here: the Transparency in Coverage data is larger than Netflix's entire movie catalog. That’s an enormous amount of information to parse and analyze. Another intriguing point is that private equity companies might be driving up health care costs - an influence that’s not immediately obvious. Lastly, it’s hard to find price information; it’s posted in many different places and isn’t published in a standard format.
This discussion underscores the transformative potential of having comprehensive data on health care prices, yet it also highlights the technical and logistical hurdles that still need to be addressed to fully leverage these insights for systemic change.
Join us for this year’s Health Datapalooza on September 4 and 5 in Washington D.C. We’ll have interactive workshops, unconference sessions, and networking opportunities for data innovation stakeholders to exchange ideas and expertise.
Earlier interviews in this series are available here. LibreChat was utilized to generate key takeaways from the interview transcript. The substance of the post was written by a human author.