The nation's Blue Cross Blue Shield plans are jumping into big data--in a big way.
The Blue Cross Blue Shield Association (BCBSA) announced Thursday that all of its 36 member companies will contribute healthcare quality and cost information to BCBS Axis, which the company bills as the "largest database in the healthcare industry."
Axis will aggregate secure cost data from more than 2.3 billion procedures each year, from 96 percent of all hospitals in the country and 92 percent of doctors, according to the BCBSA. That data will also reflect more than $350 billion in annual claims, 36 million provider records and information from every ZIP code in the country.
Axis was an initiative that was "years in the making" for the BCBSA, Maureen Sullivan (pictured right), the association's chief strategy officer, tells FierceHealthPayer in an exclusive interview.
The association recognized that data is a strategic asset, and it needed to step up the amount of information it made available to employers, members and provider partners, she says, adding, "the kind of collective commitment there is to take data to the next level."
The database provides two primary advantages, BCBSA CIO Doug Porter (pictured left) tells FierceHealthPayer. For consumers, they are better informed with this data at their fingertips.
And for health plan account decision-makers, "they now have fuller visibility and transparency" to guide employees to seek out the best point of service for their care, Porter said.
In addition, providers can benefit by using the data to benchmark care delivery patterns, which allows them to drive more coordinated, patient-centered care, according to the BCBSA.
With such a large-scale database, however, privacy concerns are bound to arise. In fact, Blues plans Anthem, Execellus, CareFirst and Premera all have suffered data breaches in recent months, which is likely why BCBSA announced that starting in January, it will offer free identify protection for all of its 106 members.
Axis protects BCBSA customers by de-identifying data, Sullivan explains. And as Porter adds, "We don't need to know who's behind that data. We just need to know what's behind the data. So at some level we can do a lot of analytics and inform aggregate cost of care down to the ZIP code level, even at a provider level, without knowing who the members are."
Furthermore, Porter says, "we've taken some pretty decisive actions at the board level to make sure that we're scanning all of our environments for appropriate controls and to make sure that we don't have any evidence of any compromises of our infrastructure."
The BCBSA is not the only entity to try to harness the power of health insurance claims data to improve care quality and control costs. Many of these efforts have taken place at a more regional level, including an online data-sharing initiative between Colorado insurers and various states' all-payer claims databases.
Yet Axis has an advantage over all-payer databases because it allows members to see how care cost and quality data relates directly to their individual benefits, according to Sullivan.
"If you're going off to get a knee surgery, you want to know what it means to your costs, given your benefits and what you've spent already this year. I don't think you much care about what someone else has. It's what's going to matter to you," she says. "And what we're doing is giving a depth of information so those decisions can be made on an individual level, all through the local health plan."
To learn more:
- here's the announcement
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