Health Law

HEALTH CARE DATA CHASE: THE ARRIVAL OF HEALTH CARE ALL CLAIMS DATA BASES.

By Greg Piche'

    The Colorado legislature is about to address a proposal to develop a state health care all claims data base as part of Governor Rittter?s health care initiative package. The pending bill, HB 1330, provides for the structure and development of a claims data base in the state with the hope of joining a number of other states that have already or are in the process of developing their data bases.  

    Other states include Maine, Minnesota, Maryland, Tennessee, Vermont, New Hampshire, Florida, Oregon, Utah and Arizona. The espoused benefits of the claims data base are said to be,

•     Cost and Quality Transparency ( Are the most costly providers the most effective?).

•     Population Health Management ( Are state funds being allocated to the areas of the state where they are most needed?).

•     Medical Management ( Can outcomes be improved with more transparency in actual practice?).

•     Program Evaluation and Decision making ( Is the allocation of public resources and efforts paying appropriate dividends or should changes be made?).

•     Comparative effectiveness research (What works and what doesn?t?).

•     Health policy formulation simulation ( What direction should health policy take for the most effective return?)

    Several national organizations have arisen to promote the development of state data bases. NAHDO, the National Association of Health Data Organizations focuses on assisting states with their data base development efforts. RAPHIC, the Regional All Payer Information Council, attempts to coordinate data collection standards and systems so as to provide interchangeability between various state efforts for state to state and region to region comparisons.  Last December, the federal Department of Health and Human Services (?HHS?) announced its own efforts to develop a national claims data base, apparently because of concern about  balkanization of state efforts and results. There is a study underway to consider the viability and methods of developing the national data base.  

    Having real data available to consumers begs the question of whether consumers will really utilize the data in making health care insurance and treatment decisions. Some probably will. Many probably will not. Perhaps the bad actors will be outed and the effective practitioners and their methods identified.  Hopefully  we can be saved from the possibility that the whole effort will descend into a cacophony of ?lies, damned lies and statistics.? In any event, the states are acting while the federal government is studying. Interesting times ahead for health care providers and consumers.

Full post as published by Healthcare Law Blog on February 21, 2010 (boomark / email).