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Why Payer Data Matters to Consumers and Tech Brands

In health care, the enforcement of hospitals and insurance companies to publicly share information on the price of health care services enables patients and consumers to identify, compare, and choose providers that offer the desired level of value for the medical care they need.

Transparency for cost of services is critically important to many people who may pay out of pocket as part of their deductible, or if their care isn’t covered. From a consumer standpoint, forcing insurers to be less opaque is welcome news.

Commercially, it provides an unprecedented opportunity for life science companies to understand which health care providers and systems are reimbursed the most for the procedures and supplies they market and sell. For tech brands within medtech, biotech and life sciences, the resulting data is a trove of information that gives valuable industry insights.

For consumers wondering if the data releases personal information: it does not.

This information is anonymized in regard to the patient. What it does offer is a list of services and products billed by procedures and conditions, by location.

Payer Data Use Examples

Consider an orthopedic procedure for example, such as a knee replacement. Patients undergoing knee replacements may be told that part of the procedure, or recuperative accessories such as a brace, are not covered under their insurance at their desired hospital. They can now “shop around” to see what costs are commonly associated with a knee replacement, what they can expect to be on their bill (and hold the care/billing team accountable) while also determining the cost for a given type of postoperative accessory. They never see identifying patient details, only that a given location performs x number of knee replacements and what the associated costs of those procedures entails.

Now consider a biotech company that designed a brace that demonstrates reduced wear time and increased ROM outcomes over its top 3 competitors. This company is interested in disrupting the market, and accessing market share in the hospitals that currently have established vendors for postoperative accessories. Their first step is to determine which locations represent the market they want a share of, and then to see if their competitors are currently servicing those markets. Next, they would want to get materials and information about their product in front of the right audience. Because individual data is anonymized, this is a geo-strategic initiative. Knowing exactly which knee procedures are executed in specific facilities, and which of those required postoperative braces greatly enhances the capabilities of marketing and sales teams. This is the value brought to tech brands by the release of payer data.

Insider Tip: The files are “machine readable” by law, but they are HUGE and not easily consumed by the humans that can benefit most from the information, especially because insurance companies published them under duress.

That’s where we can help with our data science as a service. Our skills slice and dice the available data in a way that makes it possible for life science brands to analyze the market and take action. Learn more about this process through our free marketing playbook for life sciences. We’re happy to meet with you and discuss your goals or talk a little more about how this data can benefit your own marketing and sales teams.