Comment by sl-dolt

2 years ago

I'm the author.

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.