We're trying to reclaim the word
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Sure. I did something like that with our insurance data. Did a quick folium visualization. You can start from here:
https://www.dolthub.com/repositories/dolthub/hospital-prices...
A limitation of our dataset is it excludes percentage-based contracts. So those won't show up.
Anyways, if you have the hospital NPI you want, you can look up all of its dollar-amount negotiated rates in this table. You can link that to the `hospital` table, geocode however you want, and make a map of the different rates. Note, however, that the insurance data published here is kind of a mess and, I think, contains many many mistakes (originating in the source data.)
BTW, I'm not sure if this insurance-derived hospital data exists anywhere else. I believe it doesn't.
Along the same lines we're crowdsourcing a database of hospital prices, starting this week. I'm reviewing our first pull request as we speak. You can follow our progress live. The data is here: https://www.dolthub.com/repositories/dolthub/standard-charge...
We talked a little about the problems we're encountering here: https://docs.google.com/document/d/1uMx1sUYwP_uE7ebd3PtGvF0t... and here https://docs.google.com/document/d/1NifwgKHBCeF35ZRZsfpgg4bE...
Please take a look at the CMS Price Transparency Guide https://github.com/CMSgov/price-transparency-guide and familiarize yourself with the schema. You can also take a look at the federal ruling: https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-...
The metadata you're talking about is specified in the files themselves. I've limited my search to fee-for-service (non-capitated, non-derived, non-bundled) institutional claims.
You can write to me if you have more questions. alec@dolthub.com
Take an example like this https://github.com/CMSgov/price-transparency-guide/discussio...
I don't know how closely you've worked with this data -- you clearly have some kind of expertise -- but how do you explain this?
The insurance companies had 18 months to talk to the CMS and ask for a better data model. If they're not able to explain how much things cost with 5 different negotiated types -- negotiated, percentage, derived, fee schedule, and capitation -- then they should have asked for another one.
The hospital and insurance rates are both fee-for-service base rates for items billed individually. If there's some nuance in interpreting how "fee for service" "dollar amount negotiated" goes, definitely write to me and let me know. I talked with experts in healthcare pricing before I published this.
You can write to me at alec@dolthub.com if you wanna hit me with more questions.
> No one can produce the corrected/missing rates but the insurance companies themselves. All we can do is point out when we’ve found rates/patterns that don’t make sense. E.g. https://github.com/CMSgov/price-transparency-guide/discussio...
We recently created this database of 70 CMS shoppable services for all US hospitals. It comes from the recently published insurance MRF data.
We created this database in a distributed way using simple tool I wrote to process the JSON. https://github.com/dolthub/data-analysis/tree/main/transpare...
Edit: Oh wow, I see you used it on those exact files. How about that.
I wrote here about our efforts to make this work and what we found: https://news.ycombinator.com/item?id=34445914
The following query will return all the prices for the billing code 85032 (manual red blood cell count) that are greater than $10:
> select npi, reporting_entity_name, reporting_entity_type, negotiated_rate from npi_rate join (select id, insurer_id, negotiated_rate from rate where ( (code_id in (select id from code where billing_code = 85032)) and (negotiated_rate)) y on y.id = npi_rate.rate_id inner join insurer on insurer.id = insurer_id order by negotiated_rate;
This is being built as we speak and will slowly grow over the next few weeks. You can join the effort in building it or you can explore and tell me what you find. alec@dolthub.com
See the article I wrote on this last month: https://www.dolthub.com/blog/2022-09-02-a-trillion-prices/
Regarding your first point:
I'm aware of the copyright on billing codes. I suspect it means "you can't make your own billing codes based off of our system."
I don't think it means you can't republish the codes anywhere. They're republished all the time.
Someone can jump in and correct me.
Secondly:
The CMS law required hospitals to itemize their procedures by billing code _and_ by insurance company. Not that they all do that, but in theory, these negotiated rates should allow you to price shop between hospitals. The "list prices" are effectively meaningless.
Aggregate data (or "list prices", MSRPs) have been available in some cases for a while now, depending on the state and context.
This is the data gathering phase. When we're able to release a database of these hospital prices with high data quality I think it'll be a pretty big deal, just because it's so much work.
It's hard as hell because of how inconsistently formatted these price sheets are. We'll need to develop a robust ML tool to process all of them in a consistent way, or just put a lot of man hours in. That's something that One Fact is working on. DoltHub's main interest is in producing the source databases, which is just a lot of grind work.
We're crowd sourcing the data collection via a "data bounty." It's like a scavenger hunt where you get paid for the data you input. I designed the table and I'm who reviews the data going in, via pull requests.
Incidentally we do have a hospital price database here (the only open one of its kind) but with mixed data quality. https://www.dolthub.com/repositories/dolthub/hospital-price-...
The inflated price you're talking about is called the "gross price." It's a made-up price, or MSRP. Just publishing this price list isn't that helpful.
The price lists are supposed to contain the negotiated rates with different insurance companies or medicare. Those reflect the rates that your insurance company pays. You pay some fraction of that depending on your plan.
Most price lists don't contain this information, though.
The purpose of the article was to see how many of them contain the elements that are required from the transparency bill, the ones which allow meaningful price comparison between hospitals. And the answer is... not that many do.
But among the ones that do, you can kinda sorta make a meaningful comparison (but there are even caveats there as well.) Feel free to follow up if you have more questions.
This blog was a feasibility analysis to see what kind of work it would take to get that data. If we do get it, we plan on making it free to download.
This won't get you all of the insurers, but it'll get you a a few of the major ones.
If you want links to the files of more insurers, here's a project from one of my friends at Postman: https://github.com/postman-open-technologies/us-cms-price-tr...