Secondary use of data takes front seat
WORCESTER, Mass.—What started an effort to compare notes on data-gathering between Maine and New Hampshire has become an initiative in nearly 15 states, with more on the way, said Josephine Porter, deputy director of the New Hampshire Institute for Health Policy and Practice. Porter made her comments during a presentation at the Massachusetts Governor’s 2011 Health IT Conference on May 10.
During breakout sessions on the use of secondary data and analytic tools to improve healthcare delivery and policy, Porter said all-payor claims databases (APCDs) could complement hospitals’ discharge databases. New England is leading the way in APCD creation and use—Maine has the oldest APCD in the nation, now age 10; New Hampshire has had one since 2005; Massachusetts, Vermont and Rhode Island are in various stages of database creation and use, she added.
Much of the work to build APCDs has been a result of the efforts to gain transparency for cost and utilization of care, said Porter. Efforts also stem from employer coalitions interested in understanding the health of their employee populations and looking at the claims data to do that, she said.
An APCD is a database created by state mandate that typically includes data from providers, pharmacies and/or dental files from public and private payors, including Medicare and Medicaid. These data are used by federal and state agencies, researchers, providers and consumers. For example, an employer might look to an APCD for information on employee health, and an employee might use it to compare healthcare plan costs and benefits, she said.
“We know there is interest on the federal government side, and they have started efforts on development of national database,” Porter said. Data in an APCD can also be used for benchmarking purposes and for viewing the relative scale of reimbursement across health plans.
Using APCD data, Porter showed a series of data comparisons highlighting procedure payment statistics for several New England states, most notably Maine and New Hampshire. One of these highlighted the difference between Medicaid and New Hampshire comprehensive healthcare information system members when examining the number of emergency room visits by age. The number of Medicaid visits was dramatically higher across the board.
Asked if there was a way for states to share data, particularly those outside of the New England region, Porter pointed to the APCD Council, a federation of government, private, non-profit and academic organizations dedicated to improving the development and deployment of state-based APCD systems. “This is a way for states to discuss, collaborate and share notes,” said Porter.
Similarly, when asked of the possibility of organizing all APCD systems into one hub, Porter indicated that there is currently a push to make APCD a national effort. An initiative has been launched to study the possibility of a multi-payor claims database (MPCD). “Just this week we have begun a fact-finding mission to research the feasibility of [an MPCD] project,” said Porter, although she acknowledged at least one major issue: “Different states have different release policies regarding data.”
A standardized method to collect and release data is only one challenge facing a cohesive APCD system, she said. Database compatibility issues and universal payment methodologies are also issues. The role of the federal government is also a question mark.
Still, APCDs hold promise for secondary data use, such as payor/plan transparency and possibly better care. “Ultimately, it comes down to how we deliver complex data to an audience,” she concluded.
During breakout sessions on the use of secondary data and analytic tools to improve healthcare delivery and policy, Porter said all-payor claims databases (APCDs) could complement hospitals’ discharge databases. New England is leading the way in APCD creation and use—Maine has the oldest APCD in the nation, now age 10; New Hampshire has had one since 2005; Massachusetts, Vermont and Rhode Island are in various stages of database creation and use, she added.
Much of the work to build APCDs has been a result of the efforts to gain transparency for cost and utilization of care, said Porter. Efforts also stem from employer coalitions interested in understanding the health of their employee populations and looking at the claims data to do that, she said.
An APCD is a database created by state mandate that typically includes data from providers, pharmacies and/or dental files from public and private payors, including Medicare and Medicaid. These data are used by federal and state agencies, researchers, providers and consumers. For example, an employer might look to an APCD for information on employee health, and an employee might use it to compare healthcare plan costs and benefits, she said.
“We know there is interest on the federal government side, and they have started efforts on development of national database,” Porter said. Data in an APCD can also be used for benchmarking purposes and for viewing the relative scale of reimbursement across health plans.
Using APCD data, Porter showed a series of data comparisons highlighting procedure payment statistics for several New England states, most notably Maine and New Hampshire. One of these highlighted the difference between Medicaid and New Hampshire comprehensive healthcare information system members when examining the number of emergency room visits by age. The number of Medicaid visits was dramatically higher across the board.
Asked if there was a way for states to share data, particularly those outside of the New England region, Porter pointed to the APCD Council, a federation of government, private, non-profit and academic organizations dedicated to improving the development and deployment of state-based APCD systems. “This is a way for states to discuss, collaborate and share notes,” said Porter.
Similarly, when asked of the possibility of organizing all APCD systems into one hub, Porter indicated that there is currently a push to make APCD a national effort. An initiative has been launched to study the possibility of a multi-payor claims database (MPCD). “Just this week we have begun a fact-finding mission to research the feasibility of [an MPCD] project,” said Porter, although she acknowledged at least one major issue: “Different states have different release policies regarding data.”
A standardized method to collect and release data is only one challenge facing a cohesive APCD system, she said. Database compatibility issues and universal payment methodologies are also issues. The role of the federal government is also a question mark.
Still, APCDs hold promise for secondary data use, such as payor/plan transparency and possibly better care. “Ultimately, it comes down to how we deliver complex data to an audience,” she concluded.