Beginning in July 2022, insurance carriers became required by CMS to post their negotiated rates as machine readable files (MRFs). Mostly published in a semi-standard JSON format, these files represent the contracts between carriers and providers, negotiated under various plans or employer group contracts for the breadth of healthcare services. These data files can be enormous and present a technical challenge to data engineers to process and filter for specific use cases. Amitech has been working since July 2022 to process and provide subsets of this data from major carriers (United, Anthem, Aetna, various BCBS plans) for specific customer use cases.
Amitech has been working with a broader set of healthcare price transparency data since January 2021, when healthcare providers (hospital systems) were required to publish their negotiated rates. At that time, providers were not given a technical standard to follow. As a result, the hospital price transparency files were published in a mish-mash of CSV, Excel, JSON, and other file types, with as many different layouts as there are hospital systems in the country. This data was not only difficult to process because of that variation but provided meaningful data in a limited scope of use cases and geographies. Still, there may be value in this data for some regions.
Where available, for current customers, you can find additional information about what each of these payers has published including notes about file format, data quality, and data volume.
For additional information, contact Amitech at email@example.com