Health Data Corner – Manatt, Phelps & Phillips, LLP

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The Health Data Corner compiles the latest innovations and policy developments in state health care data capacity, and presents a selection of new data use cases emerging from states. A PDF of our update is also available here.


  • the Delaware The Department of Insurance is seeking to codify its proposed affordability standards, which would set targets for primary care investment through 2025 through a new regulatory proposal.
  • DelawareThe Department of Health and Human Services has released a new CostAware website, which uses data from the Delaware Health Care Claims Database and publicly shares health care prices and quality data. for state suppliers. The state plans to continue integrating additional pricing data and consumer features into the website throughout the year.
  • the National Academy for State Health Policy (NASHP) released a new interactive hospital cost tool, which analyzes a hospital’s annual Medicare Cost Report (MCR) to provide information on hospital expenditures on patient care services and relationship between these costs and hospital costs (list price) and the actual prices covered by mutual insurance companies. Additional resources on unique features of the Interactive Hospital Cost Calculator, such as the Trade Balance feature, are also available.
  • E. Lowry, A. Johnson, A. Hunt and T. Lee’s recent Health Affairs piece examines the performance of the state in the Altarum Healthcare Value Center‘s 2021 Healthcare Affordability State Policy Scorecard, which examines four key areas: reducing excessive prices in the system, reducing low-value care, extending coverage to all residents, and making out-of-pocket costs affordable.


To return to the Manatt Cost Containment update home page, please click here.

  • “How to get a health data infrastructure fit for this moment in Medicaid transformation», Health Affairs. January 18, 2022. Claudia Williams, CEO of Manifest MedEx, California’s leading health data network, and former White House senior health technology and innovation adviser, outlines three principles states can follow to make progress bold and actionable steps toward building smart data infrastructure to support Medicaid transformation.
  • “Improving Race and Ethnicity Data: A Roadmap for Measuring and Advancing Health Equity”, Healthy donors (GIH). December 2021. In a new report, GIH, in collaboration with the National Committee for Quality Assurance (NCQA), discusses the collection of race and ethnicity data in federally administered health programs and presents several recommendations to improve this data. These findings and recommendations build on a previous October 2021 report that examines barriers and opportunities to improve the completeness, accuracy, and usability of race and ethnicity data at state levels. and the federal government.
  • “The Colorado IT Roadmap for Healthcare”, Colorado Office of Electronic Health Innovation (OeHI), November 2021. Colorado has released a new report that outlines a series of recommendations to “harness and expand digital tools and services that support the health of all Coloradans.” The three main objectives of the roadmap are: to ensure that stakeholders share data and have equitable access to necessary health and social information; facilitate access to high-quality, in-person, virtual and remote health services; and improve health equity through inclusive and innovative use of digital health informatics and solutions.
  • “Report of the All Payers Database Advisory Committee with Recommendations under Section 735 of the Employees Retirement Income Security Act 1974», October 2021. Under Section 735 of ERISA, SAPCDAC was tasked with advising the Secretary of Labor regarding the standardized reporting format for voluntary reporting by group health plans to databases of all payors in the State. Data standardization recommendations from the SAPCDAC report include:

     
    • Use of the APCD Common Data Layout (APCD-CDL) as the standard reporting basis for data submission of self-funded schemes to APCDs;
    • Work with states to capture non-claims payments and other data needed to support cost and usage analyses;
    • Creation of a detailed data dictionary for the elements included in the APCD-CDL data layout

    The report also presents additional recommendations for data submission; confidentiality, security and dissemination of data; voluntary submission of data; and more.

  • “The History, Promise and Challenges of State All Payer Claims Databases,” Briefing Note for the State All Payer Claims Database Advisory Committee to the Department of Labor, RAND Healthcare. June 2, 2021. Using a literature review focused on the APCD, an environmental scan of the APCD websites, and several key informant interviews, RAND summarizes several key findings about the state of APCDs and the events that led to their development and use.

To return to the Manatt Cost Containment update home page, please click here




APCD Updates

  • As of 2021, six states are considering or have passed new legislation establishing All Payers Claims Databases (APCDs), including:

     
    • Alaska Senate Bill 93 was reviewed in 2021 and referred to the Finance Committee for further study; this legislation follows a feasibility analysis carried out in 2020;
    • Indiana House Bill 1402 was signed by the Governor in April 2021, establishing an APCD;
    • Nevada Senate Bill 40 was signed by the Governor in June 2021, establishing an APCD, following a 2020 request for information;
    • Tennessee House Bill 1258 was considered in April 2021 to establish an APCD using Consolidated Appropriations Act (CAA) funds and was sent to “summer study” by the insurance subcommittee;
    • Texas House Bill 2090 was signed by the governor in June 2021, establishing a statewide APCD to “increase public transparency of health care information and improve the quality of health care in the state.” », as of September 1, 2021; and
    • West Virginia Senate Bill 390 moved the State Health Care Authority under the state Department of Health and Human Services (DHHS), from a separate entity, and gave authority of the APCD to the Secretary of DHHS, effective when adopted in March 2021.

Other data updates

  • The Health Care Cost Institute (HCCI) has released several new reports, including:

     
    • One on supplier price variation, revealing significant variation in median prices for specific services both between metro areas and within metro areas;1 and
    • Another on the impact of COVID-19 on service utilization, which revealed significant reductions in preventive services in 2020 compared to 2019, including childhood vaccinations, mammograms and pap smears, colonoscopies and prostate cancer screenings.

  • The National Association of Insurance Commissioners (NAIC) Special Committee on Race and Insurance has released draft Principles for Data Collection, establishing high-level guiding principles for the collection, use and regulating race, ethnicity and other demographics of enrollees in the health insurance business. These principles emphasize the expectation of health insurance companies to collect, retain, protect and report this data, and to do so in a voluntary manner that uses collection strategies and language that have been tested by consumers and widely recognized for their accuracy and responsiveness. The report also provides examples, best practices and additional resources that can be leveraged to support the implementation of such data collection.

To return to the Manatt State Cost Containment Update homepage, please click here.


1 Looking at six service items in metropolitan areas, HCCI found up to a 25-fold variation in median prices (specifically, this variation was observed for median prices for blood tests, which had a median price of $18 to Toledo, Ohio, compared to $443 in Beaumont-Port Arthur, Tex. Even in the same metro areas, some services could cost up to 39 times more (again, this observation was for median blood test prices, which at El Paso, Texas had the biggest variation: $808 difference in their 10and and 90and price in percentiles).


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