Posted on December 18, 2014

Media Contact:
Larry Bernard, NEHI
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All Payer Claims Databases Provide Great Opportunity for Improving Health Care Delivery

But states underutilize their full potential, experts say

CAMBRIDGE, MA (December 17, 2014) – All Payer Claims Databases across the country are providing unprecedented research and policy opportunities to improve health care delivery, according to a new policy paper published today by NEHI (Network for Excellence in Health Innovation).

But the databases are only starting to be used to their full potential as policymakers grapple with issues of how to best use the system, experts convened by NEHI said.

“States are following very different strategies to prove the value of the system and to make it worthwhile to stakeholders,” the NEHI report says.  Massachusetts, for example, is partnering with state agencies to simplify administrative functions and create a broad network of support for the APCD. The state is exploring a future partnership with the Department of Public Health to link vital records and cancer registry with the APCD system. 

Colorado, on the other hand, hopes to build partnerships with commercial entities, such as digital health innovators and technology developers creating new opportunities to push the data out to the health care community.

“Experts broadly agreed that the greatest value will be in providing data that is actionable,” the NEHI paper says. The issue brief was written by Erin Bartolini, program director, and Rebecca Paradis, senior health policy associate. It is a result of an expert roundtable discussion that NEHI convened in November 2014, along with current research on the state of APCDs.

Experts also said that broad data access is important and that the data should be shared externally, but only with proper checks and balances. “States with data release policies must define principles for research that meets the public interest, and then assess requests in line with those standards,” the report says. “For many states this is a delicate subject.”

NEHI’s panel of experts found that APCDs are already proving valuable in understanding cost and utilization across populations over time. But to achieve broader potential, the following issues warrant further attention:

  •  Integrating with non-claims sources such as vital records, patient registries, clinical data, and patient reported surveys
  • Utilizing patient identified data for limited circumstances to better understand patient histories, practice patterns and long-term outcomes
  • Exploring new partnership opportunities within the academic and commercial communities on new data uses and analysis

 The report concludes: “While the focus of APCD efforts … has been … within state government policy … there is enormous opportunity for other health sectors to become involved in these initiatives and to take the APCD system capability further.”

 The way to do that: All sectors must be at the table to discuss how to best unlock the potential of these efforts, the authors write.


About NEHI 
NEHI (Network for Excellence in Health Innovation) is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs. In partnership with members from all across the health care system, NEHI conducts evidence-based research and stimulates policy change to improve the quality and the value of health care. Together with this unparalleled network of committed health care leaders, NEHI brings an objective, collaborative and fresh voice to health policy. For more information, visit Follow us on Twitter at @NEHI_News and like us on Facebook at NEHINews.

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