State all-payer claims databases: tools for improving health care value. Part 1, How states establish an APCD and make it functional

State all-payer claims databases: tools for improving health care value. Part 1, How states establish an APCD and make it functional

Collection:
Health Policy and Services Research
Author(s):
McCarthy, Douglas, author
Contributor(s):
Commonwealth Fund, issuing body.
Publication:
[New York, New York] : The Commonwealth Fund, December 2020
Language(s):
English
Format:
Text
Subject(s):
Databases as Topic
Insurance, Health, Reimbursement
State Government
Value-Based Purchasing
United States
Genre(s):
Technical Report
Abstract:
ISSUE. All-payer claims databases (APCDs) can facilitate state efforts to control the rising cost of health care and increase its value. By aggregating data on the health care services that health insurers and public programs pay for, they offer a broader perspective on cost, service utilization, and quality than any single entity can provide. An increasing number of states are creating or are implementing APCDs. GOALS. Synthesize experiences and lessons learned from the creation and implementation of eight diverse, state-level APCDs, including their intended uses, formation, governance, funding, staffing, use of vendors, sources and types of data collected, linkages with other data, analytic capabilities, and privacy practices. METHODS. Interviews with APCD staff and stakeholders and a review of documentary evidence. KEY FINDINGS AND CONCLUSIONS. State approaches to APCD development varied from governmental initiatives and public-private partnerships to voluntary efforts. Successful implementation requires engaging with stakeholders; establishing salient use cases; determining a suitable governance structure; securing sustainable funding; setting realistic implementation goals and timeframes; and ensuring data quality and analytic rigor while protecting data privacy.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
Extent:
1 online resource (1 PDF file (16 pages))
Illustrations:
Illustrations
NLM Unique ID:
101774902 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/101774902