The problem of bias is one of the potential pitfalls of creating a healthcare price transparency tool. If the tool is offered by an insurer or a hospital, consumers might not trust that the data is fair and accurate, rather than intended to drive them to a particular provider.
Fair Health, which recently launched a new consumer-facing app in the state of Connecticut, has an advantage in this area. The nonprofit organization was founded as part of a settlement between the New York Attorney General's office and the state's health insurance industry, and its whole mission is to provide a nonbiased dataset for governments, researchers, insurers, and the public.
"We have over 21 billion claims that represent the experiences of approximatey 150 million people around the country," Fair Health Founding President Robin Gelburd told MobiHealthNews in an interview. "What’s unique about our websites and mobile apps is one, it’s fueled by the data that we collect. Two, that we’re completely independent and conflict-free. There’s no bias or other information that’s impacting on the information that we do disseminate. Three, we offer it in English and Spanish."
Fair Health launched web-based consumer-facing transparency tools shortly after it launched in 2009. The company launched its first mobile app in 2011 and added a Spanish language version in 2015. The new app, funded by a grant from the Connecticut Health Foundation, is the first to focus on a particular region, providing hyperlocal data for users in New York, Connecticut, Rhode Island, or Massachussets.
"Whether it’s what kind of exchange, how their Medicaid program is administered, each state is its own living laboratory of healthcare and healthcare reform," Gelburd said. "So we were very privileged and delighted that the Connecticut Health Foundation chose to issue us a grant to build on the platform we already had but really enhance it to make it a Connecticut-centric experience, adding content that is particular to Connecticut area residents."
Gelburd says that part of Fair Health's mission is not just to collect a robust data set and make it available to all stakeholders, but also to make sure that the information is presented in a way that overcomes language and health literacy barriers. That's why the app is translated into Spanish, and also translates local procedure codes into Spanish so it can help Spanish-speakers understand their medical bills.
"We think it’s wonderful that there’s a spotlight right now on providing consumers with cost transparency tools, but that’s not really enough," Gelburd said. "At Fair Health we strive for clarity versus transparency because just making something transparent and available may not necessarily advance the decision-making of the consumer. So we do that in a number of ways. First of all, we presume no knowledge of the consumer coming into this app. We have extremely clear glossaries both for insurance terms as well as medical and dental terms to help consumers make sense of what they’re looking at."
"Next, our data are very granular, so ... it would give you the specific procedure code that’s tied to [your care]," Gelburd continued. "Why that’s critical is consumers can use the tool to have conversations with their physicians about the cost of the procedure. They can also, when they get their medical bill, they can see very clearly what was provided and then look at the cost so they can make sure there’s accuracy there. So if a cost transparency does not offer a specific procedure code, there’s no apples to Apples comparison for the consumer to have that meaningful dialogue."