FAIR Health Consumer Access

External Research

External researchers rely on FAIR Health data for a broad array of studies featured in prominent journals and government reports. This year’s external research included studies from the Government Accountability Office and Health Affairs; the subjects ranged from imaging to dental economics.

Marcus Shaker et al., “Estimation of Health and Economic Benefits of Clinic versus Home Administration of Omalizumab and Mepolizumab,” Journal of Allergy and Clinical Immunology: In Practice, October 15, 2019.
This study sought to characterize cost-effectiveness of in-clinic versus at-home biologic therapy with omalizumab and mepolizumab for patients with asthma or chronic spontaneous urticaria. Costs of in-clinic administration were estimated from FAIR Health data. The results suggested that at-home administration of omalizumab and mepolizumab may be cost-effective for many patients.

Kamyar Nasseh et al., “Consolidation in the Dental Industry: A Closer Look at Dental Payers and Providers,” International Journal of Health Economics and Management, October 3, 2019.
The researchers used FAIR Health data on commercial dental insurance market concentration to study whether such concentration has an effect on the organizational structure of dental practices. The structural elements they examined were the size of dental practices, dentists’ decisions to own a practice and the choice of dentists to work at a dental management service organization. Their findings suggested that dentists consolidate in response to growing concentration among commercial dental insurers.

Loren Adler et al., “California Saw Reduction in Out-of-Network Care from Affected Specialties after 2017 Surprise Billing Law,” USC-Brookings Schaeffer on Health Policy (blog), September 26, 2019.
This analysis from the USC-Brookings Schaeffer Initiative for Health Policy presented new evidence on observed changes in provider network breadth after the implementation of California’s 2017 surprise billing law. The researchers used FAIR Health private claims data to measure the share of specialty professional services provided in and out of network in California before and after implementation of the law. They reported a modest shift toward in-network care across all affected specialties that was timed to the law’s implementation.

J. Dolan et al., “Comprehensive Computed Tomography Ordering Guidelines for Odontogenic Infections,” Journal of Oral and Maxillofacial Surgery 77, no. 9, supplement (September 2019): e76-e78.
The investigators studied the potential of a radiological imaging pathway to address overutilization of computed tomography (CT) in the workup of odontogenic infections. FAIR Health data were used in cost analysis. The researchers concluded that use of an imaging pathway may decrease unnecessary CT imaging for odontogenic infections, with potential for cost savings and reduced radiation exposure.

Massachusetts Health Policy Commission, “The Price Is Right? Variation in Potential Out-of-Network Provider Payment Benchmarks,” HPC DataPoints, no. 14, August 14, 2019.
Presenting Massachusetts data from FAIR Health on several services often associated with surprise billing, this article showed how payments would vary using different out-of-network provider payment benchmarks. Procedures examined represented emergency, radiology, anesthesiology and pathology services. Benchmarks considered included 80th percentile of charges, median charge, 125 percent of median imputed allowed amount, median imputed allowed amount, 125 percent of Medicare rate and Medicare rate.

Graham W. W. Van Schaik, Katherine D. Van Schaik and Michael C. Murphy, “Point‐of‐Care Ultrasonography (POCUS) in a Community Emergency Department: An Analysis of Decision Making and Cost Savings Associated with POCUS,” Journal of Ultrasound in Medicine 38, no. 8 (August 2019): 2133-40.
This study examined the choices of community emergency department physicians regarding use of point-of-care ultrasonography (POCUS), and whether such use changed clinical management and resulted in cost savings. FAIR Health data were used to analyze cost savings attributable to POCUS. The researchers concluded that increasing the use of POCUS in community emergency medicine can reduce direct and indirect costs.

Theresa Hwee et al., “Hematopoietic Cell Transplantation and Utilization of Fertility Preservation Services,” Biology of Blood and Marrow Transplantation 25, no. 5 (May 2019): 989-94.
Because conditioning regimens for hematopoietic cell transplantation (HCT) can cause loss of reproductive function, fertility preservation (FP) services are recommended for patients at risk of such loss. Using FAIR Health data, the investigators described utilization of FP services before HCT among patients of adult reproductive age (18-40). Claims for FP services were found to be uncommon among HCT patients in that age group.

Karandeep Singh, Sean R. Meyer and John M. Westfall, “Consumer-Facing Data, Information, and Tools: Self-Management of Health in the Digital Age,” Health Affairs 38, no. 3 (March 2019): 352-58.
The authors described the major consumer-facing resources that have led patients to take a more active role in managing their healthcare. These included electronic health records, patient portals and websites for consumers. FAIR Health was cited as a price transparency resource.

United States Government Accountability Office (GAO), Air Ambulance: Available Data Show Privately-Insured Patients Are at Financial Risk, GAO-19-292, March 2019.
This detailed report to congressional committees featured FAIR Health data to study out-of-network air ambulance transport and the risk of balance billing it poses to patients. The report analyzed FAIR Health data to show that about two-thirds (69 percent) of air ambulance transports for privately insured patients in 2017 were out of network, and that the proportion was similar (75 percent) in 2012. The report noted that the proportion is higher than the rate research shows for ground ambulance transports and other types of emergency services.

Ashleigh Weyh et al., “Overutilization of Computed Tomography for Odontogenic Infections,” Journal of Oral and Maxillofacial Surgery 77, no. 3 (March 2019): 528-35.
The researchers sought to determine the rate of overutilization of computed tomography (CT) for workup of odontogenic infection, as well as the predictive value of history and physical examination (H&P) findings in diagnosing an infection necessitating CT. FAIR Health data were cited in estimating the potential for cost savings achievable by avoiding unnecessary use of CT. The study concluded that there is overuse of CT for odontogenic infections and that H&P findings can help accurately diagnose higher-risk infections.

Other Articles on FAIR Health Data
In addition to being cited by external researchers, FAIR Health data were also featured in 2019 in an article by FAIR Health President Robin Gelburd, “Putting Claims Data to Work: Using Analytics in an Evolving Healthcare Ecosystem,” in the peer-reviewed journal Management in Healthcare 3, no. 4 (Winter 2018-19): 362-75. Analytics presented in the article focused on such areas as alternative venues of care and clinical trends.

Ms. Gelburd frequently writes on FAIR Health data and related topics. For more of her articles from 2019 and earlier, see the President’s Corner.

FAIR Health data are frequently cited in media outlets that reach popular audiences and the healthcare industry. For articles about FAIR Health from 2019 and earlier, see Media Coverage.

If you are interested in learning how FAIR Health data and analytics can support your 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.