Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims Databases

For several decades, measures of health care quality have been embraced as tools for quality improvement, transparency, and accountability. As health care costs continue to rise, more stakeholders are calling for such measures to be used as part of value assessments, to understand how high health care expenditures, high out-of-pocket costs, and high local and Federal spending on health care can be shifted toward better care at better prices. One way to use measures this way is through all-payer claims databases (APCDs). The Agency for Healthcare Research and Quality (AHRQ) funded the APCD project to learn more about how APCDs are used and how their uses can be expanded. This report provides background on APCDs and the APCD project, uses of APCD-based measures, and evaluation of data from a few State APCDs.


Contents

Introduction
    Overview of All-Payer Claims Databases
    Uses of All-Payer Claims Databases
    Purpose of Project
Reviewing the Landscape of All-Payer Claims Databases
    Technical Expert Panel
    Environmental Scan
Measure Inventory
Data Evaluation of All-Payer Claims Databases
    Methods
    Results of Data Evaluation
Discussion
    Limitations of APCD Data for Measurement
    Ongoing Efforts To Improve APCD Data
Conclusion and Future Directions
References
Appendix A: Technical Expert Panel and Learning Network Members
Appendix B: Prioritization of Conditions for Measure Inventory

Prepared for:

Agency for Healthcare Research and Quality
5600 Fishers Lane
Rockville, MD 20857

Prepared by:

Stanford University (Prime Contractor)
Sheryl M. Davies, M.A.
Kathryn McDonald, M.M.

Truven Health Analytics
Erica Danielson, Ph.D.
Manju Gokhale, M.A.
Stella Chang, M.P.H.

University of California, San Francisco
Naomi S. Bardach, M.D., M.A.S.
Grace A. Lin, M.D., M.A.S.
Mitzi Dean, M.S., M.H.A.
R. Adams Dudley, M.D., M.B.A.

APCD Council
Denise Love
Ashley Peters
Josephine Porter
Emily Sullivan

Stanford University
Center for Primary Care & Outcomes Research, School of Medicine
Center for Health Policy, Freeman Spogli Institute for International Studies

The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

Disclaimer of Conflict of Interest

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

Funding Statement

This project was funded under contract number HHSA2902001200003I from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. The opinions expressed in this document are those of the authors and do not reflect the official position of AHRQ or the U.S. Department of Health and Human Services.

Public Domain Notice

This document is in the public domain and may be used and reprinted without special permission. Citation of the source is appreciated.

Suggested Citation: Davies SM., McDonald K, Danielson E, et al. Inventory and prioritization of measures to support the growing effort in transparency using all-payer claims databases. Prepared under Contract No. HHSA2902001200003I, Task Order 5. AHRQ Publication No. 17-0022-1-EF. Rockville, MD: Agency for Healthcare Research and Quality; March 2017.

Page last reviewed April 2017
Page originally created March 2017
Internet Citation: Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims Databases. Content last reviewed April 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/apcd/backgroundrpt/index.html