Payer price transparency data for academic research

What is Serif Health?

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Serif Health compiles negotiated in network rates from payers' price transparency files into a single, standardized database. It turns fragmented, inconsistent machine-readable files into cleaned, enriched datasets that make it possible to study healthcare pricing, reimbursement variation, and site of care economics at a national scale.

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What academic researchers should know about Serif Health payer price transparency data

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On Dewey, Serif Health publishes negotiated rate data for four of the largest national PPO networks: Aetna Open Access Managed Choice, Cigna National OAP, Blue Card, and UnitedHealthcare Choice Plus, totaling nearly 195 million rate records. Each dataset covers the 293 most commonly billed medical codes, spanning CPT, HCPCS, MS-DRG, and revenue codes, across every in network provider in the country. The data separates professional from facility billing, captures site of care differences between hospitals, ambulatory surgery centers, and physician offices, and reflects a range of negotiation types from fee schedules to per diem rates. Serif Health sources the files under the Transparency in Coverage rule, then removes mismatched rates, runs its own quality checks, and enriches the data before it reaches researchers.

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Why academic researchers choose Serif Health on Dewey

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Health plans are required to publish negotiated rates, but the raw files are famously unusable: sprawling, inconsistent, and full of errors that make direct analysis nearly impossible. Serif Health does the unglamorous work of standardizing those files into a single clean structure, saving researchers months of data wrangling before a single regression gets run. It's also the first payer price transparency dataset on Dewey, opening up a category of health economics research that used to require expensive proprietary claims data or a lot of patience with government files.

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Serif Health academic research ideas and use cases

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Why does the same knee replacement cost two to ten times more at one hospital than another a few miles away? Serif Health's negotiated rate data makes it possible to measure that variation directly, procedure by procedure, network by network, instead of relying on list prices that nobody actually pays.

As hospital systems keep merging and physician groups keep consolidating, researchers can use Serif Health data to test whether bigger systems actually negotiate higher rates, and whether market concentration is quietly driving up the price of care in specific regions.

Aetna, Cigna, Blue Card, and UnitedHealthcare do not all negotiate the same way. Comparing rates across these four networks lets researchers study how contracting strategy, network breadth, and bargaining leverage show up in the prices insurers actually pay.

A colonoscopy billed from a hospital outpatient department often costs far more than the identical procedure billed from an ambulatory surgery center or a physician's office. With nearly 195 million rate records to draw on, Serif Health's site of care detail gives researchers a direct way to quantify that gap across thousands of procedures.

The Transparency in Coverage rule was supposed to help patients and researchers see what care actually costs. Serif Health data offers an early foundation for testing whether that transparency mandate is actually working, or whether payers and providers have found new ways around it.

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