Sunday, November 20, 2011

Studying Healthcare Financing

The Health Care Cost Institute (HCCI) is going to provide researchers and policymakers access to a comprehensive collection of health plan and government payer data to gain new insights into healthcare costs and utilization. HCCI will provide access to data from plans operated by Aetna, Humana, Kaiser Permanente and UnitedHealthcare along with government data from Medicare Fee for Service and Medicare Advantage.

The data will include more than 5 million medical claim records representing more than $1 trillion of healthcare activity from over 5,000 hospitals and one million service providers from calendar year 2000 to the present. For the first time there will be comprehensive data on the privately insured that make up the majority of health consumers in the U.S according to Professor Martin Gaynor PhD of Carnegie Mellon University.

The de-identified data will be in accordance with HIPAA requirements and HCCI will establish a Data Integrity Committee whose primary focus will be on all matters related to data privacy, security, and integrity.

HCCI’s governing board will be controlled by independent national physician leaders and academic researchers to broaden the list of participating health plans and to add more data from government payers, including Medicaid. Beginning in 2012, HCCI plans to publish its own “Scorecards” that supports analysis on aggregate trends of healthcare cost and utilization.

In another project, the University of Pennsylvania Health System (UPHS) is partnering with the Leonard Davis Institute Center for Health Incentives and Behavioral Economics on a new initiative called the “UPHS Center for Innovations in Health Care Financing.”

It has been reported that the U.S. spends about $2.5 trillion per year on healthcare with costs growing at several percentage points faster than the growth of the economy. Wellness incentive programs are gaining popularity among employers and government. Medicare and insurance companies are moving to modify payment models while reducing health expenditures. However, proven models for doing so are rare and it is this gap that the new UPHS Center seeks to fill.

The new Center will combine the expertise of faculty members at the School of Medicine and the Wharton School. They will test how insights from behavioral economics and health economics can improve patient health and reduce the rate of growth in healthcare costs.