About the Pennsylvania Health Care Cost Containment Council

What We Do

PHC4 was formed under Pennsylvania statute, Act 89 of 1986, as amended by Act 15 of 2020. Under this act, we have two primary responsibilities:

• We collect, analyze, and make public data about the cost and quality of health care in Pennsylvania
• We review and make recommendations about proposed or existing mandated health insurance benefits upon request of the legislative or executive branches of the Commonwealth

Our Strategy

Our goal is to help increase competition in the health care market to contain costs for you. We do this by:

• Comparing information about the most efficient and effective health care providers and sharing our findings with consumers
• Giving this information to health care providers so they can find ways to contain costs and improve the quality of care they deliver

Strategic Plan Summary 2024-2029

PHC4 wants to thank the Council members who dedicated countless hours to this effort, alongside staff. The contributions made by these many professionals is what upholds PHC4’s outstanding reputation as a trusted source of health care data. The PHC4 community is energized by the opportunity to expand its reach in reporting and awareness as we work toward the achievement of the goals outlined here under our newly established mission statement. We look forward to carrying on the legacy of transparency and nonpartisan reporting that was established in 1986, ensuring it continues now, and into the future.

Mission

PHC4 empowers Pennsylvanians through transparency, providing access to data, research, analysis, and reporting focused on the cost, utilization, and quality of health care delivery in the Commonwealth.

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Goals

Quality and Payment Data

• Provide access to insurer cost estimator tools on PHC4’s website to facilitate comparisons
• Evaluate physician-specific volume
• Continual integration of SDOH data, and alignment with federal standards in defining categories like race/ethnicity in PHC4 reporting
• Evaluate physician-specific volume
• Evaluate procedures performed in the ambulatory/outpatient setting
• Collect payment/cost data & report costs of health care in Pennsylvania
• Compare inpatient versus outpatient care volumes and costs
• Evaluate physician-specific outcome measures
• Evaluate subsequent inpatient admissions that are related to procedures performed in the ambulatory/outpatient setting
• Report the average overall costs per condition at an aggregate level and across varied settings

Governance

• Create dedicated opportunities for strategic discussion by Council, including a summary of PHC4’s report topic decision-making process
• Increase PHC4 state appropriations to cover operating expenses
• Create a vision statement
• Development of proposed updates, with bipartisan agreement, to PHC4’s enabling legislation

Communications and Education

• Build PHC4 awareness within defined stakeholder groups
  • Patients, Legislators, Health Care Communities, Labor/Business Entities, and the Education/Research Population
• Build awareness of PHC4 Data Client experience, output, and value

PHC4 Strategic Plan 2024-2029

Our Data

We collect inpatient hospital discharge and ambulatory/outpatient procedure records from hospitals and freestanding ambulatory surgery centers in Pennsylvania. This data, which includes hospital charge and treatment information as well as other financial data, is collected on a quarterly basis.

Once we have this data, we compile it into free public reports that can be found on our website. Since our creation, we’ve published hundreds of public reports about health care in Pennsylvania.

We’ve also produced hundreds of customized reports and datasets through our Special Requests division for a wide variety of users, including hospitals, policy-makers, researchers, physicians, insurers, and other group purchasers.

Our Funding

We’re funded through the Pennsylvania state budget. We also receive revenue through the sale of our data to health care stakeholders around the state, the nation, and the world.