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All-Payer Claims Databases set stage for data-driven healthcare and big analytics

If you haven’t heard of an APCD, it’s one of those acronyms you need to know. All Payer Claims Databases are simply databases that consist of claims data from all health care payers in a given state. This includes private payers such as Blue Cross Blue Shield, and public payers such as Medicaid or Medicare. As you can imagine, it’s a lot of data, and it certainly fits the mold of “big data” Moreover, APCDs are setting the stage for data-driven healthcare and big analytics.

Colorado’s APCD website recently went live and I spent some time playing around with the maps and report generation tools. It’s great to see population health and health metrics visually, and Colorado is to be commended for its APCD’s public interface. Giving the public access to this information will empower Colorado’s citizens to make better decisions about their health care.

All that’s been done with APCDs to-date is great, but on my team of analytics obsessives, we like to continuously ask the question “so what?” What does that mean to the policy maker, the end user, and ultimately to the recipient of services? Now that we have all of this information in one place, how are we maximizing its use to essentially transform a system? With the data in the APCD there are certainly a lot of decisions on the payer, provider, and patient level that can be made. For instance, payers can identify what they’re spending the most on, providers can modify their treatments to be more effective, and patients can be empowered to make better choices. But, what does this mean to really enhancing quality and reaching our ultimate goal of improving health? This where the opportunity to leverage analytics comes into play. Not just any analytics, but advanced analytics. Predictive analytics.