The American Healthcare Conundrum

Data Access Fund

Every dollar buys data, not salary. Every analysis is open-source. Every finding is reproducible.

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Total Raised $0 of $44,000
Free data found $428.6B/year in fixable waste. These datasets let us prove it at patient level.
$3,500
Phase 1: Claims Access
$9,000
Phase 2: Multi-State + Legal
$44,000
Phase 3: Full Medicare (65M patients)
🔓
Already have access to one of these datasets?

If you hold an active DUA for CMS LDS, VRDC, a state APCD, or HCUP data, you can collaborate directly. Your existing access + our published code = findings neither of us could produce alone.

Get in touch
📦
Can your organization donate proprietary dataset access?

We're seeking licensed-tier data that would unlock issues we cannot fully quantify with public sources. Currently on the wishlist: Truven/MarketScan, Optum Clinformatics, IQVIA Pharmetrics, Definitive Healthcare, Press Ganey, Sage Transparency. Donations can be public or anonymous. Co-publication under your DUA is fine. Code stays open. Findings stay published.

Donate access
Phase 1 — Claims Access
1
CMS Medicare Claims (5% Sample)
$1,500
$0 raisedGoal: $1,500
Claim-level Medicare data with diagnosis codes, procedure codes, and denial outcomes. Transforms 6+ issues from aggregate inference to patient-level evidence.

Source: CMS via ResDAC. Data Use Agreement required (no fee), 2-3 week approval. 5% random sample of all fee-for-service Medicare: inpatient, outpatient, physician, SNF, home health, hospice, DME.

IssueWhat becomes possible
#8 DenialsWhich diagnoses denied most. What happens after denial: ER visits, readmissions, mortality.
#9 Low-Value CareFlag specific procedures with high geographic variance and no outcome benefit.
#14 Facility FeesSame-procedure cost at hospital outpatient vs. physician office, claim by claim.
#16 UpcodingDRG severity shifts over time. Which hospitals changed coding without changing patients.
#22 FFS TrapFFS vs. MA utilization for same conditions. The empirical volume premium.
#25 End-of-LifeSpecific high-cost, low-benefit interventions in final 6 months of life.
Sponsors
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2
Colorado All-Payer Claims Database
$2,000
$0 raisedGoal: $2,000
Every commercial, Medicare, and Medicaid claim in Colorado. The only way to see what private insurers actually pay. 5.5M lives.

Source: CIVHC (civhc.org). CO Health Foundation offers up to $50K/project in grants to offset costs, so this may ultimately cost nothing out of pocket.

IssueWhat becomes possible
#3 Hospital PricingActual negotiated rates by hospital and insurer. Ground-truth the RAND 254% finding.
#4 PBMsDrug-by-drug comparison: what plans pay PBMs vs. what pharmacies receive.
#8 DenialsFirst independent analysis of commercial insurer denial rates at claim level.
#10 ConsolidationPrice changes at hospitals before and after system acquisitions.
State SpotlightsFull claim-level Colorado analysis by hospital, insurer, and procedure.
Sponsors
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Phase 2 — Multi-State + Legal
3
Hospital Discharge Data: California + New York
$1,000
$0 raisedGoal: $1,000
Every hospital inpatient discharge in the two largest state markets. All payers. If a finding holds in CO, CA, and NY, it's national.

Source: AHRQ HCUP State Inpatient Databases. ~$500/state. California: 400+ hospitals, 3M+ discharges/year. New York: 200+ hospitals. Student/nonprofit discounts available.

IssueWhat becomes possible
#9 Low-Value CareIdentify unnecessary inpatient procedures by volume, geography, and hospital across 3 states.
#16 UpcodingDRG severity distributions at hospital level, multi-state. Flag outlier coding patterns.
#25 End-of-LifeRegional comparison of aggressive end-of-life care intensity.
Sponsors
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4
Hospital Price Transparency (Full National)
$3,500
$0 raisedGoal: $3,500
1 billion+ negotiated rate records. What every hospital charges every insurer for every procedure. The most consumer-facing dataset on this list.

Source: Turquoise Health. Free tier covers 14 procedures; full dataset covers thousands. Research partnership may reduce cost. Derived from CMS-mandated public hospital price disclosures.

IssueWhat becomes possible
#3 Hospital Pricing"Your hospital charges UnitedHealthcare $47K for a hip replacement. Across town: $29K." Real prices people can look up.
#10 ConsolidationPre- and post-merger negotiated rates at acquired hospitals, procedure by procedure.
#14 Facility FeesSame CPT code at hospital outpatient vs. ambulatory surgery center. Real prices, not estimates.
Sponsors
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5
Legal Research (Case Law + Antitrust)
$1,200
$0 raisedGoal: $1,200
Full US case law. FTC antitrust opinions, merger challenges, PBM litigation, Safe Harbor history. Answers "how did the system get this way?"

Source: Midpage (midpage.ai). $99/month, cancel anytime. Already configured as a live connector in our research environment. Just needs activation.

IssueWhat becomes possible
#4 PBMsFull text of FTC antitrust cases and settlement terms.
#10 ConsolidationEvery FTC hospital merger challenge. Court opinions on market definition and competitive harm.
#11 GPOsAnti-Kickback Safe Harbor legal history. Challenges to the 1987 exemption.
#31 CapstoneFiduciary duty case law. Can shareholders sue for prioritizing extraction over outcomes?
Sponsors
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Phase 3 — Full Medicare Access
6
CMS Full Medicare Claims (65M Patients)
$35,000
$0 raisedGoal: $35,000
100% of Medicare claims, including Medicare Advantage. Patient-level, longitudinal. The same data Harvard, Dartmouth, and RAND use. For less than the cost of one junior researcher.

Source: CMS Virtual Research Data Center (VRDC) via ResDAC. ~$35K first year ($23K renewal). Full DUA + IRB approval required. Virtual-only access (no data downloads). All outputs reviewed by CMS for patient privacy.

This is the dataset that produces JAMA-publishable, congressionally-citable findings. It lets us follow individual patients across time, link denials to outcomes, trace spending through vertically integrated systems, and answer questions no other dataset can.

IssueWhat becomes possible
#8 DenialsFollow every denied MA patient. ER visits, readmissions, mortality. The actual human cost of wrongful denials.
#9 Low-Value CareEvery unnecessary procedure for 65M patients, linked to outcomes. The definitive national overuse estimate.
#10 ConsolidationPatient-level cost changes before/after mergers. Evidence an FTC proceeding could cite.
#16 UpcodingFull DRG distribution for every Medicare hospital. Flag implausible coding with statistical precision.
#22 FFS TrapSame demographics in FFS vs. MA. The definitive fee-for-service volume premium.
#31 CapstoneTrace patient flows through vertically integrated systems. Are UNH patients funneled to Optum at higher cost?
Sponsors
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What "Open Source" Means Here

What
Shareable?
Analysis code
Yes, always. Every script, every model. Published to GitHub.
Findings
Yes, always. Hospital stats, denial rates, cost comparisons. Published in the newsletter and on GitHub.
Derived tables
Yes, with cell suppression. No cell under 11 observations (CMS privacy rule).
Raw claims
No. Patient privacy. Any researcher can get their own access and run our code.
The model: We buy access. We publish the code. We publish the findings. CMS actually requires researchers to publish as a condition of access. Any researcher with their own DUA can reproduce every result.

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Contributions are project funding, not tax-deductible charitable donations.

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