According to the New York eHealth Collaborative’s newsletter “NYeC News”, the State Department of Health (DOH) is developing an All-Payer Database (APD) to serve as a repository for claims data drawn from all major public and private payers and if possible combine this data with clinical and public health data sources.
ADPs can support state level healthcare reform efforts by providing powerful tools to evaluate critical issues such as regional variations in utilization, quality, and costs. In addition, APDs are used to examine the impact of reimbursement methodologies, study public health interventions, and examine how healthcare resources are utilized in terms of quality, outcomes, and/or costs.
Nine states have created APDs such as Kansas, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, Tennessee, Vermont, and Utah. Three additional states are in the process of implementation and fourteen states have either taken initial steps toward creating an APD or have established a voluntary system.
New York passed the legislation building on the existing Statewide Planning and Research Cooperative system (SPARCS) to create an APD. The SPARCS collects clinical and demographic data on hospital discharges, emergency department visits, and certain ambulatory surgery and clinic visits.
The new APD system may be developed within SPARCS or as a separate entity, but either way it will include claims data related to inpatient, outpatient, emergency department, laboratory, pharmacy, and other healthcare services.
Currently the project is in the initial planning phase. In June, the New York State Health Foundation in collaboration with Commissioner Nirav Shah and the New York State Department of Health hosted a working discussion with various healthcare stakeholders regarding the establishment of the database.
At the meeting, the Office for Health IT Transformation presented an inventory of the existing data resources in New York that need to use payer data. The databases currently in operation include SPARCS, FAIR Health, New York Quality Alliance, and a state funded project in the Adirondacks.
At this point, the DOH after hearing the input is planning to reach out to a larger group of stakeholders to create a roadmap for implementation, locate potential funding sources and define requirements, as well as present a framework for an overall architecture model. In addition, a cross-cutting group within DOH will work on the regulations described in the legislation to address the collection and use of the data as well as provisions to protect patient privacy.