Healthcare claims database at a standstill after vendor goes belly-up

Utah's statewide repository of medical and pharmacy insurance claims so far hasn't delivered on its promises. On top of that, the state Department of Health employees building it have moved on to other jobs and its data-mining vendor, New Jersey-based Care Advantage, went out of business. As a result, reports comparing the quality at various health centers have not materialized.

Barry Nangle, the interim director of the health department's Office of Health Care Statistics, however, told the Salt Lake Tribune that there is some good news. "The database wasn't satisfying all the users who emerged since we started collecting the data," he said. "Now we're engaging stakeholders in a broader development process than was dictated by the Legislature."

Consumer advocates, meanwhile, are calling for increased funding for Utah's All-Payer Claims Database, conceived in 2008 as a way for consumers to comparison shop for doctors, clinics and hospitals that deliver the best care for the best price.

According to the Tribune, 15 states have such databases, citing New Hampshire as an example where consumers can shop by ZIP code for rates on a mammogram or colonoscopy.

So far, though, Utah hasn't replaced Care Advantage, and the department isn't staffed or equipped to do complicated queries. Clinicians and researchers face delays in getting the data they seek.

Still, Deputy Health Director Robert Rolfs told the Tribune, "this will free us to change directions and build a more flexible system."

A report from June looking at value-based healthcare in 12 countries called for better data standards and patient registries to overcome the complexity and fragmentation of healthcare in the United States.

The Centers for Medicare & Medicaid Services last December opened an extensive Medicare claims database, paving the way for data-rich performance report cards that evaluate providers on quality.

These statewide data-sharing projects, though, tend to hit rough waters. Kansas's health information exchange, an independent, quasi public body, recently voted to dissolve itself and turn its operation over to the Kansas Department of Health and Environment. It was having trouble getting providers to pay user fees to cover its projected $400,000 annual operating cost once its federal funding runs out in 2013.

To learn more:
- read the Tribune article

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