New healthcare pricing resource quantifies costs of complete episodes of care
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This new dataset offers both benchmark charges and allowed costs, specific to 493 regions across the country, for procedures related to defined episodes. The benchmarks are based on market-level data from privately billed healthcare claims contributed to FAIR Health by insurers and claims administrators; they represent the claims experience of more than 150 million individuals nationwide.
Benchmarks are available for more than 40 common procedures and illnesses, ranging from hip replacement to diabetes care. For each episode, the product identifies the costs of treatment based on the total costs for all procedures and services that compose a patient's beginning-to-end treatment path for a specific condition or procedure. For example, in the case of a hip replacement, the episode might include the cost of physician and surgeon consultations, anesthesia, the surgery itself, medications, physical therapy and other required services.
The FH Episodes of Care Benchmarks product also allows users to adjust cost estimates based on a patient's specific profile--including up to five common comorbidities and five risk factors per episode--providing an exceptionally precise, real-world view of overall expenses. Thus, depending on the severity of patients' conditions and associated comorbidities, tailored, risk-adjusted cost estimates can be developed.
The FH Episodes of Care Benchmarks uses the PROMETHEUS Payment® model of
"It is truly exciting to marry
Keywords for this news article include: FAIR Health, Risk and Prevention.
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