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It’s interesting that so many commentators are blaming the insurers here. The whole article is about how insurers use rules engines and lookups to define these
by kasey_junk 3y ago
It’s interesting that so many commentators are blaming the insurers here. The whole article is about how insurers use rules engines and lookups to define these prices and that the data explosion was a result of the legislation requiring price lists instead of an open standard for describing rules and lookups.
- brendanyounger 3y agoHaving worked with this data extensively (tynbil.com) and talked to several payers and providers, I don't think any of this intentional. CMS did their best at guessing what format the payer data could be exported to (with little to no help from the payers themselves). None of the payers have exactly the same schema for defining these rates as they all have home-grown solutions developed over decades. That said, most insurers have gone out of their way to bury us in data. The result is messy and annoying, but not impossible to work with. It's the best we can expect in this imperfect world.