Sources & Evidence
Built on public data sources
Every Health Worth estimate is grounded in peer-reviewed research, federal datasets, and standards-setting bodies. Browse the full bibliography below - grouped by what each source contributes to the model.
Pricing data
FAIR Health Consumer Cost Lookup
FAIR Health, Inc.
Used for: Procedure pricing benchmarks (in-network and out-of-network)
Transparency in Coverage - Machine Readable Files
Centers for Medicare & Medicaid Services (CMS)
Used for: Negotiated rates for shoppable services (45 CFR 147.211)
Hospital Price Transparency Data
Centers for Medicare & Medicaid Services (CMS)
Used for: Hospital chargemaster and payer-specific negotiated charges
Medicare Physician Fee Schedule
Centers for Medicare & Medicaid Services (CMS)
Used for: Reference reimbursement rates for clinician-billed procedures
Medicare Physician & Other Practitioners - by Geography and Service
Centers for Medicare & Medicaid Services (CMS) Data API
Used for: National average Medicare payment per HCPCS/CPT code, used as a dated cross-check on our procedure pricing
National Health Expenditure Projections
Centers for Medicare & Medicaid Services (CMS), Office of the Actuary
Used for: Projected annual health spending growth rate applied as the trend factor on future medical costs
Turquoise Health hospital rates (Data Community Tier)
Turquoise Health (nongovernment external pricing-data source)
Used for: Payer-negotiated rates, estimated allowed amounts, and discounted cash prices published by hospitals, read on a schedule into a local cache and used only where it passes Health Worth's confidence rules
Medical Expenditure Panel Survey (MEPS)
Agency for Healthcare Research and Quality (AHRQ)
Used for: Average out-of-pocket and total spending by condition
Exempt Organizations Business Master File
Internal Revenue Service (IRS)
Used for: Directory of registered 501(c)(3) nonprofit organizations by state and ZIP code, used to surface local help-paying-for-care options
Clinical outcomes
PubMed (NCBI E-utilities API)
National Library of Medicine, NIH
Used for: Recent peer-reviewed citations per procedure, refreshed quarterly and shown as Related Research (titles and links only)
HCUP Nationwide Inpatient Sample
Agency for Healthcare Research and Quality (AHRQ)
Used for: Complication rates, readmission rates, and inpatient outcomes
USPSTF Recommendation Statements
U.S. Preventive Services Task Force
Used for: Evidence-graded benefits and harms of preventive care
CDC WONDER
Centers for Disease Control and Prevention
Used for: Disease incidence, prevalence, and mortality baselines
Cochrane Database of Systematic Reviews
Cochrane Collaboration
Used for: Pooled effect sizes for treatment vs. delay decisions
Global Burden of Disease Study
Institute for Health Metrics and Evaluation (IHME)
Used for: Disability-adjusted life year (DALY) and risk-factor estimates
Quality-of-life (QALY) weights
ICER Value Assessment Framework
Institute for Clinical and Economic Review
Used for: Cost-effectiveness thresholds ($100,000-$150,000 per QALY)
Tufts CEA Registry
Tufts Medical Center, Center for the Evaluation of Value and Risk in Health
Used for: Published utility weights and cost-per-QALY ratios by condition
EQ-5D Population Norms
EuroQol Group
Used for: Baseline health-state utility values for U.S. adults
Medical Expenditure Panel Survey - SF-6D / EQ-5D
Agency for Healthcare Research and Quality (AHRQ)
Used for: Condition-specific QALY decrement estimates
Labor & productivity
Current Population Survey - Median Weekly Earnings
U.S. Bureau of Labor Statistics
Used for: Median daily earnings used to value lost workdays
American Time Use Survey
U.S. Bureau of Labor Statistics
Used for: Time spent on caregiving and recovery activities
Work Productivity and Activity Impairment (WPAI) Questionnaire
Reilly Associates
Used for: Presenteeism and absenteeism estimates by condition
Integrated Benefits Institute Health and Productivity Benchmarking
Integrated Benefits Institute (IBI)
Used for: Employer-side cost of absence and disability by condition
External pricing-data source
Turquoise Health
Turquoise Health is a nongovernment pricing-data source. Its data is kept distinguishable from CMS and other federal data.
- Who originally publishes the data
- Hospitals and facilities, in the machine-readable price files they are required to publish. Turquoise Health collects and normalizes those files; it is not the original publisher of the rates.
- What Health Worth reads
- The hospital rates table in the Turquoise Health Data Community Tier dataset (HOSPITAL_DATA.HOSPITAL_RATES), joined to the matching hospital provider records for location. Health Worth does not use any Turquoise patient, claim, or clinical data.
- What the prices are
- Payer-negotiated dollar amounts, estimated allowed amounts, and discounted cash prices that hospitals publish under price-transparency rules, along with Turquoise's own median and 10th/90th percentile fields and an outlier flag.
- Coverage today
- Hospital-published rates for the billing codes Health Worth has mapped, in Tennessee, New York, and Alabama. Coverage varies by procedure, facility, payer, and state; most of the country is not covered yet.
- How Health Worth uses it
- Only as an additional market observation where it passes Health Worth's own confidence rules. It is never treated as what a person will owe, and it never overrides a federal benchmark silently — every result names the source that produced it.
- Live or cached
- Cached. A scheduled background job queries the dataset and writes results to a local table. Nothing a visitor does triggers a query to Turquoise.
- Refresh schedule
- The background job runs continuously in small slices, working through the mapped services and states and re-reading each one on a rolling basis. Rows not seen in a run are marked inactive rather than deleted.
- Filtering before use
- Rows Turquoise flags as outliers are dropped. Unpriced rows are dropped. Duplicate provider/payer/plan rows collapse to the most recently ingested rate. Provider-eligibility rules for the service are applied. Ranges are reported as median with 10th and 90th percentiles, never minimum to maximum.
- Limitations
- Published rates are not a quote and are never automatically treated as what a patient will owe. Availability varies by procedure, geography, facility, payer, amount type, and data quality. Files differ in quality between hospitals, a single billing code rarely covers a whole episode of care, and a statewide distribution can hide large differences between nearby facilities.
- Kept separate from government data
- A result produced from these observations is labelled as external pricing data on the result itself. CMS federal benchmarks are labelled separately, and the two are never merged into a single unattributed number.
- Access and attribution
- Accessed under Turquoise Health's own data terms through their Snowflake dataset. Health Worth does not describe this as public government data, and no credentials or contract terms are published here. Turquoise Health has not endorsed Health Worth.
Don't see a source you trust?
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