In May 2014, the Health Care Cost Institute (HCCI) announced a new national health care cost and quality transparency initiative. The initiative is supported by Aetna, Humana, and UnitedHealthcare; other payers will be announced shortly. The presentation will provide background information on HCCI and describe the initial release of the three tier public transparency website that HCCI is developing. Tier 1, the public website, will be launched by 12/31/15 and was the focus of the discussion.

1. HDC Webinar Series
The Health Care Cost Institute’s
National Transparency Initiative
Dr. David Newman, Health Care Cost Institute
Introduced by Dwayne Spradlin, CEO, Health Data Consortium

2. Health Data Consortium Webinar
David Newman,
Executive Director, HCCI
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3. About HCCI
HCCI is a non-profit, independent, non-partisan research
institute dedicated to creating the United States’ most
comprehensive source of information on health care activity
and promoting research on the drivers of health care costs
and utilization.
– Public mission - improving US health system by creating
comprehensive data infrastructure and analytics
– Research - We currently hold claims, with allowed amounts, for
more than 50 million Americans, from 2007 onward which we
make available for academic, non-commercial research

4. Organization
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Governing
Board
External
Advisor(s)
Researchers Payers
Aetna
Humana
Kaiser Permanente
UnitedHealthcare
Scientific Research
Committee (SRC)
Data Integrity
Committee (DIC)
Health Care
Cost Institute
Non-Profit

5. Governing Board
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Stephanie J. Carlton, R.N., M.B.A. is currently an expert consultant at
McKinsey & Company
Almeta Cooper, J.D., Associate Vice President for Health Sciences and
Executive Director for HHS Advocacy, Regulatory and Quality
Improvement Programs at the Wexner Medical Center at the Ohio State
University
Dr. Leemore Dafny, PhD., Herman Smith Research Professor in Hospital
and Health Services, and a Professor of Management and Strategy,
Kellogg School of Management, Northwestern University
David Dranove, Ph.D., Walter McNerney Professor of Health Industry
Management, Northwestern University
Jonathan Gruber, Ph.D., Professor of Economics, Massachusetts Institute
of Technology
Stephen Parente, Ph.D., Chair, Professor of Health Finance and
Insurance, University of Minnesota
Theodore A. Prospect, F.S.A., M.A.A.A., Chief Actuary, UnitedHealth
Center for Health Reform and Modernization
Dale Yamamoto, F.S.A., M.A.A.A, F.C.A., Independent Actuary

6. Current HCCI Data
• As of April 2014, HCCI holds data on 50 million
people per year (2007-2013)
– Initial supporters: Aetna, Humana, Kaiser Permanente and
UnitedHealthcare; new participants: Assurant Health
– Administrative Claims; employer-sponsored insurance,
individual insurance; Medicare Advantage (Part C)
– Data for every state and the District of Columbia
– Updated annually (2012 data available now); 2013 data
were processed in July and available in fall
– HIPAA-compliant, de-identified.
• Hold Vermont data for generally public reporting
purposes; other APCD data

7. Future HCCI Data
• By end of 2014
– Medicare (2009-onwards) through Qualified Entity
Program
• Part A (100%)
• Part B (100%)
• Part D (~40%)
• In 2015
– Tricare
– State APCDs
• Other commercial data – additional insurers
• SGR fix – Medicaid and CHIP

8. HCCI Reports and Issue Briefs
All free and on the web

9. Health Affairs

10. Independent Research

11. Academic Research Partnerships
HCCI has signed letters of intent with leading research,
actuarial, and government organizations for non-
commercial, non-proprietary, faculty, association and
government research studies and PhD dissertations.
Academic Partners
Dartmouth Yale
Penn Michigan
Minnesota MD Anderson
Northwestern One more to be announced
Medpac Congressional Budget Office
Academy of Actuaries Society of Actuaries

12. A Few More Points before . . .
• HCCI does not engage in any commercial proprietary
research
• The data contributors do not gain access to the
combined dataset
• HCCI does not perform commercial proprietary
research for the data contributors
• Everything is in the public domain and free
• We believe we are building out an essential part of
the health services research infrastructure – join the
effort

13. HCCI Transparency Tool
HCCI motivation:
• Consistent with our public mission
• We already had the data
• By working with insurers we have the
resources to pursue
Our original interest arose around Cycle III Grant
program
We can do it well – we can do it nationally. As a
nonprofit, our focus will be to deliver a best value
tool

14. Goals of the Transparency Initiative
1. Create a common consumer
experience that is the private
sector equivalent to
www.medicare.gov
2. Provide consumers with cost and
quality information, regardless of
insurance status. It will be free to
consumers
3. Give consumers a credible,
accurate data source through an
independent nonprofit
4. Improve markets by providing
accurate information to
consumers

15. Other Benefits of the Transparency
Initiative
• Achieve economies of scale
in creating a single source for
educating consumers that
also has the deep data to
inform that education
• Serve Medicaid and
Medicare managed care
• Drive standards on quality and cost. More reliable reported
values through the use of bigger data. [New partners
around integrated delivery and new payment models.

16. Introducing the go-to source for
independent cost and quality data
A free public-facing website:
• No registration
• No password
• No user identifier
• We will report data in as much specificity as the ‘thickness’ allows
(Nation, Region, State, MSA, zip code)
• We will report average prices paid for care, treatment and procedures
by procedure and episode along with descriptive statistics
• We will provide quality information and related consumer education.
This information will become more robust over time as we develop
industry standards and enhance site functionality.
We are designing an effective consumer experience,
easy to understand and navigate.
Initial release by Dec. 31, 2014

17. Consumer functionality
• Baseline site will present average cost data that serves as a
‘reference price’ for consumers.
• Information will be presented in a way that explains likely experience in a
care pathway– including total cost, the additive components, and quality
measures, where available.
• Costs will be geography-based
• Enhancements include severity, gender, and age search to better
refine cost, standardized quality information and expanded
comparative ability across search dimensions.
• Members of participating payers will have access to password-
protected cost and quality information to include copays, deductible,
network and insurer-specific quality information.
Baseline
public site
(Dec 2014)
Enhancements
Member
password
functionality
(2015)

18. Who the product serves
• The tool’s primary audience will be consumers
seeking health care cost information for themselves
or others.
• Secondarily, the tool will provide information to
interested media outlets, policy makers, providers,
academics and industry experts for research or
communications purposes.
• The tool will be available to anyone with a web
browser and internet access.
• HCCI is talking with several states about using the
site as a price/quality portal for state employees and
a quality portal for Medicaid.
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19. Creating value through collaboration
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• HCCI’s approach to transparency is unique:
• Access to unparalleled data set
• Ability to bring together diverse stakeholders to gain
consensus
• Serving a public, non-commercial mission
• A common industry-wide website delivers value:
• For consumers: Recognize and remember one source for
reliable cost and quality information (regardless of insurance
status or insurer)
• For providers: Industry-wide quality measures calculated
by independent organization
• For insurers: More reliable quality point estimates, and
shared investment in infrastructure

20. A Few More Points again . . .
• While each insurer is free to continue to maintain their own
website, it is HCCI’s hope that their efforts become redundant
• When logged in, an insured can access only their insurers’
information
• Insurers will not be able to use this tool to compare their
commercial arrangements
• This is not a plan compare tool for employers nor is it a tool for
shopping for insurance
• Some initial discussion about having this also be a provider
portal for updating networks so information is current