More work needs to be done on Oregon’s all payer, all claims database before state officials have a better grasp of healthcare costs and an idea of which services are being used more than others, according to a recent report given to the Health Policy Board.
Such a system, which was given the go-ahead by the Legislature in 2009, collects a wide variety of data from health insurers, third party administrators, Medicaid, Medicare and pharmacy benefit managers.
The data, which is largely financially-oriented, includes information on claims, plan payments, a member’s cost sharing responsibilities for co-payments, coinsurance and deductibles, diagnoses and procedures performed, a member’s age, gender, race/ethnicity data, and whether the treatment they received was inpatient, outpatient, or from an emergency department.
Oregon began collecting data in the fall of 2010. Since then, approximately 153 million claims have been submitted by 37 payers, according to Gretchen Morley, the Oregon Health Authority’s director of health analytics. During those two years, a “back of the envelope” estimate of those costs are roughly $27 billion.
Currently, the all payer, all claims system is not collecting data for Medicare fee for service, uninsured and self-pay, and stand alone dental and vision coverage, but eventually that will happen, Morley said.
It is unclear when that will occur. Neither Morley nor spokespeople from the Oregon Health Authority returned a call for comment.
via Initial All Payer, All Claims Data Reveals a Lot of Unknowns | The Lund Report.