Enformia Acta Wireless Healthcare Provider Charge Variance

Enformia Acta Wireless Healthcare Provider Charge Variance

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Lack of price transparency in the U.S. health care market has resulted in an absence of cost accountability and competitive market based pricing for services. Enformia and Acta Wireless used the Enformia Informatics Platform to cross-reference, aggregate and analyze Medicare Inpatient and Outpatient Payer Claims Data against Medicare Hospital Compare, US Census (2010), American Community Survey (2009-2011), and Consumer Price Index (2012 Averages) data. The Enformia Informatics Platform is a real-time multi-dimensional data integration, management, and analysis platform that makes it easy to model, aggregate, cross-reference, align, and visualize disparate data from multiple systems and data sources. All the visualizations, except for the summary node were generated by the Enformia Platform.

Our focus was on comparing the charge variance, the difference between what providers charge and what Medicare pays, against a number of relevant factors to better understand what might influence charges and how health care outcomes are affected. Our analysis explored what factors might have the greatest impact on justifying the charge variance between Charge Master price lists and Medicare prices and if higher prices actually improved patient experience, performance, quality, and health outcomes.

We hope that this set of visualizations allows the public to gain insight into health care charges in regard to medical quality and performance as well as societal factors. Consumers will now be able to view this analysis to better understand that higher charges may not ensure more effective treatment or higher customer satisfaction.

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