Hilltop researchers Morgan Henderson, PhD, and Morgane Mouslim, DVM, SCM, have published an article in the August 2024 issue of The American Journal of Managed Care titled Cross-Validation of Insurer and Hospital Price Transparency Data. The first research of its kind, the piece compares the two different federally mandated sources of public, freely available health services price transparency data (insurer and hospital) for prices for maternity-related services negotiated between Blue Cross & Blue Shield of Mississippi and 26 Mississippi hospitals. Drs. Henderson and Mouslim examined the procedure code overlap for these pricing data sources, and then, for overlapping procedure codes, assessed price congruence. They found low levels of overlap: only 16.3% of hospital-billing code combinations appear in both data sources. However, for the overlapping observations, price concordance is high, with 77.4% of prices matching to the penny. The relatively low degree of overlap between the two pricing data sources indicates significant administrative misalignment between these pricing files; however, the strong concordance of overlapping prices suggests that these data sources are capturing pricing information from the same underlying contracts, as intended.
This study is part of the ongoing research conducted by The Hilltop Institute on price transparency. Read more about this research here.
Media Contact: Marsha Willis
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