Don't Get Spooked by Health Care Data: Tackling Zombie Rates and Ghost Networks
Price transparency and provider directory data can provide valuable insights on the competitive landscape and network adequacy for health care services. However, because of the sheer volume and complexity of these data, they remain largely untapped by providers and payers.
On Thursday, November 2, 2023, from 12:00 to 1:00 p.m. ET (9:00 to 10:00 a.m. PT), Mathematica Senior Researcher Evelyn Li and Veda’s CEO and Co-Founder Meghan Gaffney discussed how innovative technology can help unlock the potential of health care data. Participants learned about the following:
- New price transparency data that health insurance plans must publish under recent federal mandates and challenges with these data. For example, zombie rates appear for providers who have never provided certain services.
- Mathematica’s approach to validating and making sense of the price transparency data.
- Challenges with network adequacy facing health plans—and ultimately, their members. For example, nonexistent or unavailable providers in plan directories, commonly referred to as ghost networks.
- Veda’s approach to producing accurate provider directories and helping health plans fill network gaps.
- How integrating high quality price and directory data can help enhance the efficiency of health care delivery, reduce price variation, and improve access.
