Claims Data to Improve Health in North Carolina: A Report from the NCIOM Task Force on All-Payer Claims Database

Published April 18, 2017

One tool to assist in improving the experience of care, reducing the cost of care, and improving population health in North Carolina is an All-Payer Claims Database (APCD). An APCD is an extensive database that collects claims data from public (Medicare, Medicaid, state health plans) and private health insurance payers. APCDs can be used to inform public health and public policy priorities, evaluate the outcomes of public health programs and policies, determine the actual cost of health care in a state, provide consumer transparency, analyze geographic variation in health, and more. Task Force on All-Payer Claims Database

Abstract

One tool to assist in improving the experience of care, reducing the cost of care, and improving population health in North Carolina is an All-Payer Claims Database (APCD). An APCD is an extensive database that collects claims data from public (Medicare, Medicaid, state health plans) and private health insurance payers. APCDs can be used to inform public health and public policy priorities, evaluate the outcomes of public health programs and policies, determine the actual cost of health care in a state, provide consumer transparency, analyze geographic variation in health, and more.

 

This report discusses the findings of the NCIOM All-Payer Claims Database Task Force funded by The Duke Endowment. The charge of the APCD task force was to study the use case of an APCD for North Carolina, examine alternatives to a state-based APCD, and evaluate options for implementing an APCD in North Carolina, including an assessment of legislative interest, governance, and finance. The task force also examined the 22 states with an active APCD or an APCD under development to inform the discussion and identify best practices for implementation. This task force report includes actionable recommendations to move forward towards the creation of an APCD.