5 ways IT helps make sense of costs
July 9, 2013 in Medical Technology
Most healthcare stakeholders and observers can agree that the way healthcare costs are determined and communicated is, to put it mildly, a bit nonsensical. One of the biggest problems is that patients – the actual consumers of healthcare services – usually know nothing about the cost of what they’re buying.
Enter FAIR Health, a non-profit organization that emerged in 2009 as part of a legal settlement between the state of New York and the insurance industry. The lawsuit stemmed from then Attorney General Andrew Cuomo’s contention that there was a conflict of interest involved in insurance companies setting out-of-network costs of healthcare services using data owned and managed exclusively by the insurance industry.
FAIR Health was created to bring transparency to the process and valuable information to healthcare consumers looking for services not covered by their regular policies.
According to Robin Gelburd, FAIR Health’s president, IT plays an indispensable role in the organization’s work.
“We need an enormous IT capability to collect and synthesize cost data,” she said recently. Moreover, given that part of FAIR Health’s charge is to make the data available to researchers, that data must be more than simply collected and stored.
“It’s one thing to show a mountain of data,” Gelburd explained. “But if that mountain isn’t making sense to the consumer it’s of no use.”
As Gelburd sees it, there are five significant benefits to FAIR Health’s IT-based programs.