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Shedding Some Much Needed Light on the Health Care Market

As an economist, I understand all too well that there can be no meaningful and well-functioning market without accessible and actionable information to inform consumer choices. Health care is no exception, yet we currently have very few places to turn for data that helps us make educated purchasing decisions that drive value into the system. Fortunately this situation is beginning to be addressed nationally through Health Care Cost Institute’s (HCCI) national claims database and CIVHC’s more robust Colorado All Payer Claims Database (APCD).

Announced yesterday, the HCCI project makes 3 billion insurance claims from the three top private insurers available to researchers to identify the factors that drive increases in health care spending at the national level. This is a great step in the right direction for our country. Until now, such analysis was focused on the small subset of Medicare data, which limited us to making general statements about health care trends nationally. With the initial launch scheduled for later this year, Colorado’s APCD will provide a much more comprehensive view of the state’s health care landscape, eventually containing claims from all the commercial, public (Medicare and Medicaid), small group, and self-insured payers. By 2014, the APCD will include claims information for 90% of Colorado’s 4.2 million insured lives providing an unprecedented opportunity for in-depth analysis of health care expenditures and utilization patterns across the state.

Because the Colorado APCD will be far more comprehensive than any similar data source, it will provide information that allows consumers to price shop for health care the same way they do for other types of goods and services. In fact, we received a phone call yesterday from someone without insurance who was looking for a way to figure out how much a procedure was going to cost her. Unfortunately, we had to tell her that the APCD isn’t up and running yet, but it’s that kind of useful information that will be available to the citizens of our state to inform their health care decisions.

An initial report based on analysis of the national HCCI data found that higher prices, as opposed to greater use of services, are the primary drivers of recently observed increases in health care spending. With the APCD, Colorado will have far more extensive data necessary to do similar and more detailed analysis. My role as Director of Data and Research for CIVHC will be to analyze the Colorado APCD information and generate meaningful, user-friendly reports that uncover the key factors that drive increases in health care spending by location, age group, and gender. With this information at our fingertips, we will all be able to identify health care delivery and payment system changes that will reduce health care spending and improve quality for all Coloradans.

For more information about the Colorado APCD, visit our website.
To contact Jonathan Mathieu directly, email jmathieu@civhc.org.

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