FAIR Health also offers a shared decision-making tools for your patients and their family members.
FAIR Health is a national, independent nonprofit organization, incorporated under New York law and qualifying as a public charity under section 501(c)(3) of the federal tax code. FAIR Health was established in 2009 as part of the settlement of a broad investigation by New York State into conflicts of interest involving the adjudication of claims. FAIR Health was formed as an independent organization to bring transparency, integrity, reliability and accessibility to healthcare costs and insurance information for all healthcare stakeholders.
FAIR Health is regarded as a fair and neutral provider of robust data and data tools by diverse stakeholders throughout the healthcare sector. FAIR Health produces a variety of data resources, including standard cost benchmarks to reflect charging and payment practices for specific procedures, and customized research datasets and visualization dashboards and tools to reveal provider performance, epidemiological trends, treatment protocols, healthcare system transformation, reimbursement practices and the efficacy of public health interventions, among other uses.
In addition, FAIR Health’s data power a free, award-winning consumer website and mobile app, in English and Spanish, which empower consumers to estimate and plan for their healthcare expenditures and offer a rich educational platform on the fundamentals of health insurance.
FAIR Health is not affiliated with any governmental agency, insurer or other organization in the healthcare sector. Evident throughout our business practices, FAIR Health’s independence starts with our corporate structure. FAIR Health is governed by a conflict-free, uncompensated Board of Directors comprising leaders with experience in all segments of healthcare, including providers, hospitals, insurers, consumers, researchers, educators and policy makers. FAIR Health’s integrity and independence are also evidenced by the inclusion of its data as an official benchmark in a wide variety of state health-related laws, regulations and programs and by the inclusion of its data in numerous federal studies and reports as the “primary source.” Our integrity and independence are further evidenced by our outreach to expert advisors who have helped shape our statistical methodologies, technology infrastructure, policies and procedures, and auditing and validation protocols and, ultimately, by the trust our clients place in the quality of our data products.
FAIR Health’s database of private healthcare claims information—the largest in the nation—currently contains more than 33 billion claim records for medical and dental services from 2002 to the present and is growing by more than 2 billion new claim records per year. FAIR Health data are submitted by over 60 national and regional payors and third-party administrators who insure or process claims for private insurance plans (both fully insured and self-insured plans), covering individuals located in 493 geozip regions across all 50 states; Washington, DC; Puerto Rico; and the US Virgin Islands. Geozips tend to track with the first three digits of a zip code, although data can also be configured into state values, rural/urban clusters, census regions and/or medical service areas.
FAIR Health licenses its privately billed data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees.