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Striding into a better health plan thanks to HHS Data Sets

Americans are digital consumers.  We’re trained to expect the effortless, personalized shopping experiences we receive when booking flights on Kayak, monitoring our credit spend on Mint.com, or even paying our taxes with TurboTax.  But finding a health insurance plan isn’t that easy.  Yet.

We launched Stride Health last year because we’re hell-bent on translating healthcare into language we can all understand.  But we couldn’t have done it without the Affordable Care Act, the HITECH Act, and liberated CMS & HHS data sets.

The problem we’re solving.

Stride is the first health insurance recommendation engine, tuned and tailored to the lives of individual consumers.  The average consumer is willing to spend 9 minutes choosing a plan so often ends up taking an “educated guess.” And picking up the phone isn’t a great option — the typical health insurance exchange call center wait time is the better part of an hour.

It’s time for a new vocabulary: insurance in the context of the individual.  We set out to ensure consumers can make a logic-driven decision in 9 minutes or less,  without confusion and without resorting to educated guesses.

Stride delivers the perfect plan match to keep your doctors, lower your drug costs, and seamlessly manage your family's health spend via a ground-up approach to consumer product development.

The Affordable Care Act blew the market wide open.

To Washington, the Affordable Care Act is about making coverage possible.  For Stride Health, it's about making coverage meaningful.

While the ACA has opened up an opportunity to deliver health insurance to millions of new customers, we’re pushing that opportunity a step further by personalizing health insurance. For the first time in 50 years, American consumers can truly understand the complex, expensive product they invest in.  And they’re well-equipped to use the insurance product they have purchased.

Stride Health empowers the consumer as the new 'informed payer.’

Stride's secret sauce.

Stride’s patent-pending recommendation algorithm delivers plans to consumers by providing the first "apples-to-apples comparison" of total annual costs: premiums plus expected out of pocket spend.  An individual can enter as much, or as little, information as she wants about her personal health profile to refine the forecast and plan recommendation.  

Think of it as boiling down a health plan to the 3 or 4 data points that truly matter to that individual.

We’ve built a rich suite of data sets to help people keep their doctors, price their drugs and plan for care — all before they buy insurance.  To make this possible, Stride's team also rebuilt and cleaned core health plan data — everything from benefits models to formularies and doctor networks — in order to evaluate every available plan on the market.

Making HHS data sets actionable for American consumers.

None of this would be possible without a deep stack of public, private and proprietary data sets. On day 1, Stride Health leveraged a variety of HHS data sets like the Health Plan Finder API and PUFs in our early product prototypes.  

Now, we’ve combined additional publicly-funded claims datasets provided by HHS like the CMS LDS data set with a variety of private pricing and treatment datasets to drive Stride’s on-the-fly forecasts and recommendations.  

Stride delivers your personalized health forecast in an instant, with the precision that can only come from a nationwide set of claims and treatment data (and a killer Data Science team!).

The HHS-collected data sets that allowed us to get off the ground quickly also gave us unparalleled glances at region-specific consumer health behavior.  In order for us to project, for example, what a Type II Diabetic is going to spend in Sacramento versus Los Angeles on-the-fly — and to do so with specificity around age, sex and other compounding factors — we needed rich national data sets that allowed us to span the lives of individual human beings across a broad set of experiences.

After our early prototypes, Stride built a proprietary blend of public and private data sets to power our plan recommendation engine.

What do we want to see next out of healthdata.gov?

We couldn’t have gotten off the ground without data sets like the FDA Drug Database, HITECH Act’s NPI files, CMS LDS Claims Data Sets and even the recently released provider payment file — and we’re looking forward to the next evolution of healthdata.gov!  

A few ideas for what we’d like to see next:

- continued transparency around doctor data, particularly practitioner-specific efficacy

- national coverage of detailed health plan data, including benefit design and geographic availability

- real-time data releases around health consumption trends

- continued push for nationwide Blue Button integration and open-data standards

There’s a lot of open road ahead in terms of how startups like Stride Health can make use of new data releases, so we have our fingers crossed that the identifiable health care practitioner data was just the beginning.

Stay tuned for the next Stride installment!

Stride Health will present their use of public sources of health data during the Health Datapalooza Datalab session on Monday, June 2, 2014.