The Department of Health and Human Services continues its rapid
roll-out of new data initiatives that bring ordinary Americans
digitally into the heart of the health care system. Today, HHS
announced the latest in these open government projects, which
collectively provide excellent examples of the goals behind opening up
data–not data for data’s sake, but data as a tool people can use to
get more involved in policy, have an impact on civic life, and
hopefully make their own lives better along the way.
Healthcare.gov grows out of a
requirement passed as part of the recently-passed health bill, the
Patient Protection and Affordable Care Act. The site features a
searchable compendium of health care insurance options, public and
private, ranging from any applicable private plans to children’s
coverage (CHIP), Medicare, Medicaid, and high-risk pools. So far as
HHS knows, this is the first web site combining public and private
options from across the country.
Those of us who have compared insurance plans know that each company
combines options in different ways, defines terms differently, and
makes it as hard as possible overall to compare their plan to any
other. We get the impression that the problems of data filtering and
curation would be easier to solved for the Search for
Extra-Terrestrial Intelligence or sequencing the human genome than for
choosing the best insurance plan.
Healthcare.gov takes some big steps toward clarity in the area of
health insurance. I had a chance to talk to Todd Park, the CTO of HHS,
about the new site, and based this blog partly on his description and
partly on a couple sample runs.
Currently, you visit the site and answer a short series of questions.
Based on your answers, it then searches its inventory of potential
coverage choices to produce a customized menu of options that may be
right for you. The site supports over three billion potential
personal scenarios (potential combinations of answers to the site’s
questions) in all.
I tried walking through the site with two typical scenarios. In the
first I came in as a typical graduating college student with no job. I
answered six questions and found seven options, ranging from Medicaid
to the high-risk pool and signing on with my parents’ plan.
In the second scenario, I answered six questions as the self-employed
head of a family with a middle-class professional income. I turned up
a few dozen plans from eleven vendors along with state-specific
information. When I clicked on a private vendor, I saw a list of their
plans with three links to key sets of information on each plan:
- View Plan Benefits
- Check For Your Doctor
- View Drug Coverage
Each link took me to the health care provider’s site, so
Healthcare.gov served here as a referral service without helping me
compare plans. That’s going to improve. Starting in October,
HealthCare.gov will also include price estimates for private insurance
plans, along with more detailed information on deductibles,
coinsurance, and copayments. This will cut through a lot of the
complexity caused by the variation I mentioned before in company
plans, and enable consumers to make head-to-head cost comparisons
between plans.
Update, 2:00 PM: Another valuable feature to be added to this site is
a calculation of how much of the premiums–customer payments–into
health care insurance actually goes to health care as opposed to
overhead.
The private insurance plan data on HealthCare.gov comes from a
market-wide data request HHS issued to all insurance carriers. Over
one thousand insurance carriers, offering many thousands
of plans, are represented on the site.
Other features of Healthcare.gov include:
-
Consumers’ rights under the health care bill–for instance, how
COBRA works, how spouses can enroll under partners’ plans and
children under 26 can enroll under parents’ plans -
Prevention tips (taken from an existing http://www.healthfinder.gov/
site) -
Quality of hospital care (taken from an existing http://www.hospitalcompare.hhs.gov/
site) -
A section on understanding the health care law
I actually think the search function, if it produces useful, practical
results, will do more to explain the health care law than any text.
Because most people (myself included) didn’t read the bill, they had
no way to tell what it meant for them and their families. Hence the
widespread distaste for a bill that makes life materially better for
many of the people who carp about it.
Healthcare.gov will (for the first time on any website) let people
evaluate different options, both private and public, and find out some
of what they actually get from Patient Protection and Affordable Care
Act. (I am not, by the way, embracing this bill as the best feasible
approach to health care. I’m just saying that it has tangible effects
on people’s access to health care, making available new options that
were closed off to them before.)
Another bit of unfinished business is the format of Healthcare.gov’s
data, which is available through a search but not yet downloadable
through an API. That feature is on the HHS to-do list. Some other data
from HHS–including the huge,
recently released set–will be available in December through a
“health indicators clearinghouse.”
The American Recovery and Reinvestment Act, and now the landmark
health care bill, have brought burdens as well as opportunities to
health care providers and the public. HHS has shown a sensitivity to
the needs of those affected by the bills, and a responsibility to make
it easier for them to get its benefits. That responsibility drove its
creation of the CONNECT project, which I
discussed in a recent interview,
and the derivative NHIN Direct
project, the topic of another interview.
while those reach out to health care providers, the new data sites
serve everyone.