Research & methodology.
A decade of published work on healthcare price transparency — peer-reviewed studies, white papers, and policy analysis — and the documented methodology built on it.
Start with the work that defines the field.
Limited Use of Price and Quality Advertising Among American Hospitals
The research program began in 2012 with a simple question: does anyone tell patients what care costs? Across 474 American hospital websites, only 1.3% advertised price. Published in the Journal of Medical Internet Research in 2013 — a decade before federal rules forced prices into the open. Everything Simple Healthcare builds traces back to this question.
Read the study:High Prevalence of Ghost Rates in Transparency in Coverage Data
Documents how widespread non-functional “ghost rates” are in federal price transparency files — and why raw TiC data can't be trusted without the cleaning layer.
Read the studyPublicationFrom Transparency to Action: Turning Price Data Into Lower Costs
The thesis behind the platform: how price information becomes lower costs — the levers, the evidence, and the practical path from files to plan decisions.
Read the paperPublicationPrice Transparency With Gaps: Assessing the Completeness of Payer TiC Data
How complete is the data the largest national payers disclose? An assessment of coverage and gaps across payer Transparency in Coverage filings.
Read the analysisNational surveyPublic Awareness and Use of Price Transparency
Findings from a national survey: what consumers know about healthcare prices, and whether the transparency tools built for them get used.
Read the reportThe method behind every number.
Peer-reviewable, and preprint-ready.
Every price, score, and recommendation links back to a documented methodology — across all data layers: the data, the joins, the weights, and the limits.
Built to the same peer-reviewable standard as our published research. Updated with each model change.
Independent from carriers — by design and structure.
No carrier ownership. No broker commissions. Simple Healthcare is paid by plan sponsors and licensed advisors.
Ten data layers, combined into one picture of price and access.
Every layer independently verifiable and peer-reviewable.
Federal Transparency in Coverage
Files from ~200 insurers (~400 plans). Negotiated rates between every payer and provider.
Hospital Machine-Readable Files
Required disclosure files from ~6,000 hospitals. Standard charges and payer-specific negotiated rates.
17 Medicare fee schedules
Physician, outpatient, ambulatory surgical, DME, clinical lab, and more — the pricing floor of the U.S. system.
Medicare & APCD claims
Comprehensive Medicare and all-payer claims database utilization for episode construction and validation.
No Surprises Act data
Out-of-network rate data used for cross-network price validation.
Proprietary provider affiliation
Provider-to-group, group-to-system, and network-participation relationships resolved end-to-end.
Provider group profiles
Web-enriched profiles across ~400,000 provider group pages.
Proprietary episode hierarchies
Episode-of-care groupings that reconstruct the whole bill — surgeon, facility, anesthesia, pre-op, post-op, PT.
Geocoded provider addresses
Millions of geocoded provider addresses for access and drive-time analysis.
Specialty drug pricing data
Medical and specialty pharmacy pricing coverage. Standard retail Rx not included.
…and hundreds of additional data sources
Supplemental pricing, provider, and utilization sources folded in as the methodology grows — each documented and independently verifiable.
The research library.
Research from the Simple Healthcare team — peer-reviewed journals, white papers, and policy analysis on price transparency and healthcare payment.
Anchoring Health Financing on Better Outcomes: System Drivers and Opportunities for Reform
ReadEducationalSenate Finance Office Hours
WatchPublicationPrice Transparency Highlights Opportunities to Reduce Healthcare Spending
ReadPublicationFrom Transparency to Action: Turning Price Data Into Lower Costs
ReadPublicationTiC Proposed Rule Comments
ReadPublicationImproving Transparency in Coverage Data: Reducing Ghost Rates, Adding Utilization, and Standardizing File Structure
ReadPublicationHistory of Price Transparency in U.S. Healthcare
ReadPublicationAetna, Cigna, United called out for price transparency failures
ReadPublicationPrice Transparency With Gaps: Assessing the Completeness of Payer Transparency in Coverage Data
ReadPublicationHigh Prevalence of Ghost Rates in Transparency in Coverage Data
ReadPublicationWhite Paper: From Data to Deal: Price Transparency Data for Private Equity Investors
ReadPublicationImproving Price Transparency Data: Recommendations From Practice
ReadPublicationHospital system market share and commercial prices: a cross-sectional approach using price transparency data.
ReadPublicationPublic Awareness and Use of Price Transparency: Report From a National Survey.
ReadPublicationImproving Hospital Compliance With Price Transparency Rules.
ReadPublicationCommercial Insurer Price Transparency: A Comparison Of Four National Payers.
ReadThird-party coverage of the research.
Independent outlets reporting on what the research found — including the transparency failures of the largest national insurers.
Announcements.
Questions on methodology?
We answer them directly. No vendor middleman.
Frequently asked questions.
What data sources power the methodology?
Federal Transparency in Coverage files from ~200 insurers (~400 plans), hospital machine-readable files from ~6,000 hospitals, 17 Medicare fee schedules, Medicare and all-payer claims, No Surprises Act data, plus proprietary provider affiliation, provider group profiles, geocoded provider addresses, and episode hierarchies. Every layer is independently verifiable.
Is your methodology peer-reviewed?
The methodology is built to the same peer-reviewable standard as our published research — the team's studies appear in peer-reviewed journals, and the platform is documented to that standard end to end. A full methodology paper is preprint-forthcoming. Every price, score, and recommendation links back to a documented method — data sources, joins, weights, and limits.
How often is the data refreshed?
Federal TiC files on the monthly cadence the rule requires. Hospital MRFs and Medicare fee schedules on their published cycles. Provider affiliation, group profiles, and geocoding refresh continuously. Every report carries the refresh timestamp for each layer that contributed to it.
Do you use actual negotiated rates or estimates?
Actual negotiated rates from the TiC files and hospital MRFs wherever they exist for the payer-provider-procedure combination. Where a rate isn't disclosed, the estimation method is documented explicitly and the estimated value is flagged — never mixed silently with actuals.
How do you handle outliers and dirty data?
Documented rules for filtering sentinel values (e.g., $0.01 or $999,999 placeholders), winsorizing extreme rates, and reconciling conflicts between hospital MRFs and payer TiC filings for the same service. The full outlier logic is in the methodology paper — not a black box.
Where can I read your published research?
Right here — the research library abovecollects our peer-reviewed publications, white papers, and policy analysis, each linking to the full piece. David Muhlestein's research program began in 2012, with peer-reviewed publications from 2013 across price transparency, value-based care, and health policy. For citation lists or preprints, email info@simplehc.com.
Can I access the underlying data directly?
Yes. Simple Healthcare Landscape is the analyst workspace for querying the full pricing dataset directly, with the same methodology exposed as documented joins and filters. Built for consultants, health-econ teams, and analysts who need to work with the data themselves.
Are you independent from insurers and providers?
Yes. Simple Healthcare is not owned by an insurance carrier or a healthcare provider. Independence is structural: we are paid by plan sponsors and licensed advisor firms.