All-Payer Claims Databases Measurement of Care: Systematic Review and Environmental Scan of Current Practices and Evidence

Appendix B. Journal Articles Included in Literature Review


  1. Bernstein JR, Bernstein J. Availability of consumer prices from Philadelphia area hospitals for common services: electrocardiograms vs parking. JAMA Intern Med 2014 Feb 1;174(2):292-3. Accessed February 7, 2017.
  2. Christianson JB, Volmar KM, Alexander J, et al. A report card on provider report cards: current status of the health care transparency movement. J Gen Intern Med 2010 Nov;25(11):1235-41. Accessed February 7, 2017.
  3. Cutler D, Dafny L. Designing transparency systems for medical care prices. New Engl J Med 2011 Mar 10;364(10):894-5. Accessed February 7, 2017.
  4. Ginsburg PB. Shopping for price in medical care. Health Aff (Millwood) 2007 Mar-Apr;26(2):w208-16. Accessed February 7, 2017.
  5. Goodman RA, Posner SF, Huang ES, et al. Defining and measuring chronic conditions: imperatives for research, policy, program, and practice. Prev Chron Dis 2013;10:E66. Accessed February 7, 2017.
  6. Hibbard JH, Greene J, Sofaer S, et al. An experiment shows that a well-designed report on costs and quality can help consumers choose high-value health care. Health Aff (Millwood) 2012 Mar;31(3):560-8. Accessed February 7, 2017.
  7. Hibbard JH, Peters E. Supporting informed consumer health care decisions: data presentation approaches that facilitate the use of information in choice. Ann Rev Public Health 2003;24:413-33. Accessed February 7, 2017.
  8. Kullgren JT, Duey KA, Werner RM. A census of state health care price transparency websites. JAMA 2013 Jun 19;309(23):2437-8. Accessed February 7, 2017.
  9. Laflamme DJ, McGrath RJ. State-sponsored public reporting of hospital quality. Health Aff (Millwood) 2011 Feb;30(2):367; author reply 367. Accessed February 7, 2017.
  10. Luft HS. Advancing public reporting through a new “‘aggregator”‘ to standardize data collection on providers’ cost and quality. Health Aff 2012 Mar;31(3):619-26. Accessed February 7, 2017.
  11. Mehrotra A, Hussey PS, Milstein A, et al. Consumers’ and providers’ responses to public cost reports, and how to raise the likelihood of achieving desired results. Health Aff (Millwood) 2012 Apr; 31(4):843-51. Accessed February 7, 2017.
  12. Peters A, Sachs J, Porter J, et al. The value of all-payer claims databases to states. N C Med J 2014 May-Jun;75(3):211-3. Accessed February 7, 2017.
  13. Rosenthal JA, Lu X, Cram P. Availability of consumer prices from US hospitals for a common surgical procedure. JAMA Intern Med 2013 Mar 25;173(6):427-32. Accessed February 7, 2017.
  14. Sinaiko AD, Eastman D, Rosenthal MB. How report cards on physicians, physician groups, and hospitals can have greater impact on consumer choices. Health Aff 2012 Mar;31(3):602-11. Accessed February 7, 2017.
  15. Sinaiko AD, Rosenthal MB. Increased price transparency in health care—challenges and potential effects. New Engl J Med 2011 Mar 10;364(10):891-4.
  16. VonStar BL. All payer claims database. Colo Nurse 2011 Nov;111(4):8. PMID:22216536.
  17. Yegian JM, Dardess P, Shannon M, et al. Engaged patients will need comparative physician-level quality data and information about their out-of-pocket costs. Health Aff (Millwood) 2013 Feb;32(2):328-37. Accessed February 7, 2017.

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Research Articles

  1. Ash AS, Ellis RP. Risk-adjusted payment and performance assessment for primary care. Med Care 2012 Aug;50(8):643-53. Accessed February 7, 2017.
  2. Baker L, Bundorf MK, Royalty A. Private insurers’ payments for routine physician office visits vary substantially across the United States. Health Aff (Millwood) 2013 Sep;32(9):1583-90. Accessed February 7, 2017.
  3. Birkmeyer JD, Gust C, Baser O, et al. Medicare payments for common inpatient procedures: implications for episode-based payment bundling. Health Serv Res 2010 Dec;45(6 Pt 1):1783-95. Accessed February 7, 2017.
  4. Chandra A, Dalton MA, Holmes J. Large increases in spending on postacute care in Medicare point to the potential for cost savings in these settings. Health Aff (Millwood) 2013 May;32(5):864-72. Accessed February 7, 2017.
  5. Chukmaitov A, Devers KJ, Harless DW, et al. Strategy, structure, and patient quality outcomes in ambulatory surgery centers (1997-2004). Med Care Res Rev 2011;68(2):202-25. Accessed February 7, 2017.
  6. Colla CH, Schpero WL, Gottlieb DJ, et al. Tracking spending among commercially insured beneficiaries using a distributed data model. Am J Manage Care 2014 Aug;20(8):650-7. Accessed February 7, 2017.
  7. Cooper GS, Kou TD, Wong RCK. Use and impact of early endoscopy in elderly patients with peptic ulcer hemorrhage: a population-based analysis. Gastrointest Endosc 2009;70(2):229-35. Accessed February 7, 2017.
  8. Dalal AA, Christensen L, Liu F, et al. Direct costs of chronic obstructive pulmonary disease among managed care patients. Int J Chron Obstruct Pulmon Dis 2010;5:341-9. Accessed February 7, 2017.
  9. Dalal AA, Liu F, Riedel AA. Cost trends among commercially insured and Medicare Advantage-insured patients with chronic obstructive pulmonary disease: 2006 through 2009. Int J Chron Obstruct Pulmon Dis 2011;6:533-42. Accessed February 7, 2017.
  10. Daniel G, Hurley D, Whyte JL, et al. Use and cost of erythropoiesis-stimulating agents in patients with cancer. Current Med Res Opin 2009;25(7):1775-84. Accessed February 7, 2017.
  11. Doshi JA, Cai Q, Buono JL, et al. Economic burden of irritable bowel syndrome with constipation: a retrospective analysis of health care costs in a commercially insured population. J Manage Care Spec Pharm 2014 Apr;20(4):382-90. Accessed February 7, 2017.
  12. Dunn JD, Pill MW. A claims-based view of health care charges and utilization for commercially insured patients with osteoarthritis. Manage Care 2009 Dec;18(12):44-50. Accessed February 7, 2017.
  13. Ellis P, Sandy LG, Larson AJ, et al. Wide variation in episode costs within a commercially insured population highlights potential to improve the efficiency of care. Health Aff (Millwood) 2012 Sep;31(9):2084-93. Accessed February 7, 2017.
  14. Fitch K, Iwasaki K, Villa KF. Resource utilization and cost in a commercially insured population with schizophrenia. Am Health Drug Benefits 2014 Jan;7(1):18-26. Accessed February 7, 2017.
  15. Fullum TM, Ladapo JA, Borah BJ, et al. Comparison of the clinical and economic outcomes between open and minimally invasive appendectomy and colectomy: evidence from a large commercial payer database. Surg Endosc 2010 Apr;24(4):845-53. Accessed February 7, 2017.
  16. Gore M, Tai KS, Sadosky A, et al. Clinical comorbidities, treatment patterns, and direct medical costs of patients with osteoarthritis in usual care: a retrospective claims database analysis. J Med Econ 2011;14(4):497-507. Accessed February 7, 2017.
  17. Gross K, Brenner JC, Truchil A, et al. Building a citywide, all-payer, hospital claims database to improve health care delivery in a low-income, urban community. Popul Health Manage 2013;16 Suppl 1:S20-5. Accessed February 7, 2017.
  18. Guerin A, Carson RT, Lewis B, et al. The economic burden of treatment failure amongst patients with irritable bowel syndrome with constipation or chronic constipation: a retrospective analysis of a Medicaid population. J Med Econ 2014 Aug;17(8):577-86. Accessed February 7, 2017.
  19. Hadley J, Reschovsky JD, O’Malley JA, et al. Factors associated with geographic variation in cost per episode of care for three medical conditions. Health Econ Rev 2014;4:8. Accessed February 7, 2017.
  20. Hagiwara M, Delea TE, Chung K. Healthcare costs associated with skeletal-related events in breast cancer patients with bone metastases. J Med Econ 2014 Mar;17(3):223-30.
  21. Hagiwara M, Delea TE, Saville MW, et al. Healthcare utilization and costs associated with skeletal-related events in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 2013 Mar;16(1):23-7. Accessed February 7, 2017.
  22. Helderman JH, Kang N, Legorreta AP, et al. Healthcare costs in renal transplant recipients using branded versus generic ciclosporin. Appl Health Econ Health Policy 2010;8(1):61-8. Accessed February 7, 2017.
  23. Higgins A, Zeddies T, Pearson SD. Measuring the performance of individual physicians by collecting data from multiple health plans: the results of a two-state test. Health Aff (Millwood) 2011 Apr;30(4):673-81. Accessed February 7, 2017.
  24. Hollingsworth JM, Norton EC, Kaufman SR, et al. Medical expulsive therapy versus early endoscopic stone removal for acute renal colic: an instrumental variable analysis. J Urol 2013 Sep;190(3):882-7., Accessed February 7, 2017.
  25. Hollingsworth JM, Saigal CS, Lai JC, et al. Medicare payments for outpatient urological surgery by location of care. J Urol 2012;188(6):2323-7. Accessed February 7, 2017.
  26. Hollingsworth JM, Saigal CS, Lai JC, et al. Surgical quality among Medicare beneficiaries undergoing outpatient urological surgery. Journal Urol 2012 Oct;188(4):1274-8. Accessed February 7, 2017.
  27. Horvitz-Lennon M, Volya R, Donohue JM, et al. Disparities in quality of care among publicly insured adults with schizophrenia in four large U.S. states, 2002-2008. Health Serv Res 2014;49(4):1121-44. Accessed February 7, 2017.
  28. Hoy T, Singhal PK, Willey VJ, et al. Assessing incidence and economic burden of genital warts with data from a US commercially insured population. Curr Med Res Opin 2009;25(10):2343-51. Accessed February 7, 2017.
  29. Hurvitz S, Guerin A, Brammer M, et al. Investigation of adverse-event-related costs for patients with metastatic breast cancer in a real-world setting. Oncologist 2014 Sep;19(9):901-8. Accessed February 7, 2017.
  30. Hussey PS, Schneider EC, Rudin RS, et al. Continuity and the costs of care for chronic disease. JAMA Intern Med 2014;174(5):742-8. Accessed February 7, 2017.
  31. Jacobson JJ, Epstein JB, Eichmiller FC, et al. The cost burden of oral, oral pharyngeal, and salivary gland cancers in three groups: commercial insurance, Medicare, and Medicaid. Head Neck Oncol 2012;4:15. Accessed February 7, 2017.
  32. Karve S, Krishnarajah G, Korsnes JS, et al. Burden of acute gastroenteritis, norovirus and rotavirus in a managed care population. Hum Vaccin Immunother 2014 Jun;10(6):1544-56. Accessed February 7, 2017.
  33. Kleinman NL, Yu H, Beren IA, et al. Work-related and health care cost burden of community-acquired pneumonia in an employed population. J Occup Environ Med 2013 Oct;55(10):1149-56. PMID: 24064787.
  34. Kocher KE, Nallamothu BK, Birkmeyer JD, et al. Emergency department visits after surgery are common for Medicare patients, suggesting opportunities to improve care. Health Aff (Millwood) 2013;32(9):1600-7. Accessed February 7, 2017.
  35. Kubitz N, Mehra M, Potluri RC, et al. Characterization of treatment resistant depression episodes in a cohort of patients from a US commercial claims database. PloS One 2013;8(10). Accessed February 7, 2017.
  36. Lang K, Patel AA, Munsell M, et al. Recurrent hospitalization and healthcare resource use among patients with deep vein thrombosis and pulmonary embolism: findings from a multi-payer analysis. J. Thromb Thrombolysis 2015 May;39(4):434-42. Accessed February 7, 2017.
  37. Lasser KE, Hanchate AD, McCormick D, et al. The effect of Massachusetts health reform on 30 day hospital readmissions: retrospective analysis of hospital episode statistics. BMJ 2014;348:g2329. Accessed February 7, 2017.
  38. Levit KR, Friedman B, Wong HS. Estimating inpatient hospital prices from state administrative data and hospital financial reports. Health Serv Res 2013;48(5):1779-97. Accessed February 7, 2017.
  39. Li T, Carls GS, Panopalis P, et al. Long-term medical costs and resource utilization in systemic lupus erythematosus and lupus nephritis: a five-year analysis of a large Medicaid population. Arthritis Rheum 2009 Jun 15;61(6):755-63. Accessed February 7, 2017.
  40. Liliedahl RL, Finch MD, Axene DV. Cost of care for common back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of osteopathy as first physician: experience of one Tennessee-based general health insurer. J Manipulative Physiol Ther 2010;33(9):640-3. Accessed February 7, 2017.
  41. Marjoua Y, Butler CA, Bozic KJ. Public reporting of cost and quality information in orthopaedics. Clin Orthop Relat Res 2012 Apr;470(4):1017-26. Accessed February 7, 2017.
  42. McGuiness CB, Hill J, Fonseca E, et al. The disease burden of pertussis in adults 50 years old and older in the United States: a retrospective study. BMC Infect Dis 2013;13:32. Accessed February 7, 2017.
  43. Mehrotra A, Liu H, Adams JL, et al. Comparing costs and quality of care at retail clinics with that of other medical settings for 3 common illnesses. Ann Intern Med 2009 Sep 1;151(5):321-8. Accessed February 7, 2017.
  44. Menzin J, Sussman M, Munsell M, et al. Economic impact of infections among patients with primary immunodeficiency disease receiving IVIG therapy. Clinicoecon Outcomes Res 2014;6:297-302. Accessed February 7, 2017.
  45. Miller DC, Gust C, Dimick JB, et al. Large variations in Medicare payments for surgery highlight savings potential from bundled payment programs. Health Aff (Millwood) 2011 Nov;30(11):2107-15. Accessed February 7, 2017.
  46. Misurski D, Lage MJ, Fabunmi R, et al. A comparison of costs among patients with type 2 diabetes mellitus who initiated therapy with exenatide or insulin glargine. Appl Health Econ Health Policy 2009;7(4):245-54. Accessed February 7, 2017.
  47. Owens GM, Olvey EL, Skrepnek GH, et al. Perspectives for managed care organizations on the burden of multiple sclerosis and the cost-benefits of disease-modifying therapies. J Manag Care Pharm 2013 Jan-Feb;19(1 Suppl A):S41-53. Accessed February 7, 2017.
  48. Owusu-Edusei K Jr, Doshi SR, Apt BS, et al. The direct cost of chlamydial infections: estimates for the employer-sponsored privately insured population in the United States, 2003-2007. Sex Transm Dis 2010 Aug;37(8):519-21. Accessed February 7, 2017.
  49. Owusu-Edusei K Jr, Gift TL, Chesson HW. Treatment cost of acute gonococcal infections: estimates from employer-sponsored private insurance claims data in the United States, 2003-2007. Sex Trans Dis 2010 May;37(5):316-8. Accessed February 7, 2017.
  50. Owusu-Edusei K, Hoover KW, Tao G. Estimating the direct outpatient medical cost per episode of primary and secondary syphilis in the United States: insured population perspective, 2003-2007. Sex Transm Dis 2011;38(3):175-9. Accessed February 7, 2017.
  51. Pelletier EM, Ogale S, Yu E, et al. Economic outcomes in patients diagnosed with systemic lupus erythematosus with versus without nephritis: results from an analysis of data from a US claims database. Clin Ther 2009 Nov;31(11):2653-64. Accessed February 7, 2017.
  52. Pelletier EM, Pawaskar M, Smith PJ, et al. Economic outcomes of exenatide vs liraglutide in type 2 diabetes patients in the United States: results from a retrospective claims database analysis. J Med Econ 2012;15(6):1039-50. Accessed February 7, 2017.
  53. Pelletier EM, Shim B, Ben-Joseph R, et al. Economic outcomes associated with microvascular complications of type 2 diabetes mellitus: results from a US claims data analysis. Pharmacoeconomics 2009;27(6):479-90. Accessed February 7, 2017.
  54. Pelletier EM, Smith PJ, Boye KS, et al. Direct medical costs for type 2 diabetes mellitus complications in the US commercial payer setting: a resource for economic research. Appl Health Econ Health Policy 2008;6(2-3):103-12. Accessed February 7, 2017.
  55. Pendergast J, Kliethermes SA, Freburger JK, Duffy PA. A comparison of health care use for physician-referred and self-referred episodes of outpatient physical therapy. Health Serv Res 2012;47(2):633-54. Accessed February 7, 2017.
  56. Pollack CE, Hussey PS, Rudin RS, et al. Measuring care continuity: a comparison of claims-based methods. Med Care 2016 May;54(5):e30-4. Accessed February 7, 2017.
  57. Priest J, Buikema A, Engel-Nitz NM, et al. Quality of care, health care costs, and utilization among Medicare Part D enrollees with and without low-income subsidy. Popul Health Manag 2012 Apr;15(2):101-12. Accessed February 7, 2017.
  58. Priest JL, Cantrell CR, Fincham J, et al. Quality of care associated with common chronic diseases in a 9-state Medicaid population utilizing claims data: an evaluation of medication and health care use and costs. Popul Health Manag 2011 Feb;14(1):43-54. Accessed February 7, 2017.
  59. Pyenson B, Scammell C, Broulette J. Costs and repeat rates associated with colonoscopy observed in medical claims for commercial and Medicare populations. BMC Health Serv Res 2014;14:92. Accessed February 7, 2017.
  60. Raborn ML, Pelletier EM, Smith DB, et al. Patient out-of-pocket payments for oral oncolytics: results from a 2009 US claims data analysis. J Oncol Pract 2012 May;8(3 Suppl):9s-15s. Accessed February 7, 2017.
  61. Ray S, Bonthapally V, McMorrow D, et al. Patterns of treatment, healthcare utilization and costs by lines of therapy in metastatic breast cancer in a large insured US population. J Comp Eff Res 2013 Mar;2(2):195-206. Accessed February 7, 2017.
  62. Regenbogen SE, Gust C, Birkmeyer JD. Hospital surgical volume and cost of inpatient surgery in the elderly. J Am Coll Surg 2012 Dec;215(6):758-65. Accessed February 7, 2017.
  63. Reschovsky JD, Hadley J, O’Malley AJ, et al. Geographic variations in the cost of treating condition-specific episodes of care among Medicare patients. Health Serv Res 2014 Feb;49(1):32-51. Accessed February 7, 2017.
  64. Reschovsky JD, Hadley J, Saiontz-Martinez CB, et al. Following the money: factors associated with the cost of treating high-cost Medicare beneficiaries. Health Serv Res 2011 Aug;46(4):997-1021. Accessed February 7, 2017.
  65. Rosen AB, Aizcorbe A, Ryu AJ, et al. Policy makers will need a way to update bundled payments that reflects highly skewed spending growth of various care episodes. Health Aff (Millwood) 2013;32(5):944-51. Accessed February 7, 2017.
  66. Russell Crane D, Payne SH. Individual versus family psychotherapy in managed care: comparing the costs of treatment by the mental health professions. J Marital Fam Ther 2011;37(3):273-89. Accessed February 7, 2017.
  67. Sato R, Gomez Rey G, Nelson S, Pinsky B. Community-acquired pneumonia episode costs by age and risk in commercially insured US adults aged ≥50 years. Appl Health Econ Health Policy 2013 Jun;11(3):251-8. Accessed February 7, 2017.
  68. Schilling MB, Parks C, Deeter RG. Costs and outcomes associated with hospitalized cancer patients with neutropenic complications: a retrospective study. Exp Ther Med 2011 Sep;2(5):859-66. Accessed February 7, 2017.
  69. Schoenfeld AJ, Harris MB, Liu H, et al. Variations in Medicare payments for episodes of spine surgery. Spine J 2014 Dec 1;14(12):2793-8. Accessed February 7, 2017.
  70. Simoni-Wastila L, Blanchette CM, Qian J, et al. Burden of chronic obstructive pulmonary disease in Medicare beneficiaries residing in long-term care facilities. Am J Geriatr Pharmacother 2009 Oct;7(5):262-70. Accessed February 7, 2017.
  71. Simpson KN, Chen SY, Wu AW, et al. Costs of adverse events among patients with HIV infection treated with nonnucleoside reverse transcriptase inhibitors. HIV Med 2014;15(8):488-98. Accessed February 7, 2017.
  72. Snow R, Granata J, Ruhil AV, et al. Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement. J Bone Joint Surg Am 2014 Oct 1;96(19):e165. Accessed February 7, 2017.
  73. Speir AM, Kasirajan V, Barnett SD, et al. Additive costs of postoperative complications for isolated coronary artery bypass grafting patients in Virginia. Ann Thorac Surg 2009;88(1):40-6. Accessed February 7, 2017.
  74. Teitelbaum A, Ba-Mancini A, Huang H, et al. Health care costs and resource utilization, including patient burden, associated with novel-agent-based treatment versus other therapies for multiple myeloma: findings using real-world claims data. Oncologist 2013;18(1):37-45. Accessed February 7, 2017.
  75. Thompson S, Kohli R, Jones C, et al. Evaluating health care delivery reform initiatives in the face of “cost disease”. Popul Health Manag 2015 Feb;18(1):6-14. Accessed February 7, 2017.
  76. Thygeson M, Van Vorst KA, Maciosek MV, et al. Use and costs of care in retail clinics versus traditional care sites. Health Aff (Millwood) 2008 Sep-Oct;27(5):1283-92. Accessed February 7, 2017.
  77. Vera-Llonch M, Weycker D, Glass A, et al. Healthcare costs in women with metastatic breast cancer receiving chemotherapy as their principal treatment modality. BMC Cancer 2011 Jun 15;11:250. Accessed February 7, 2017.
  78. Warren L, Ladapo JA, Borah BJ, et al. Open abdominal versus laparoscopic and vaginal hysterectomy: analysis of a large United States payer measuring quality and cost of care. J Minim Invasive Gynecol 2009 Sep-Oct;16(5):581-8. Accessed February 7, 2017.
  79. Weinstein SJ, House SA, Chang CH, et al. Small geographic area variations in prescription drug use. Pediatrics 2014 Sep;134(3):563-70. Accessed February 7, 2017.
  80. Wu EQ, Patel PA, Yu AP, et al. Disease-related and all-cause health care costs of elderly patients with gout. J Manage Care Pharm 2008 Mar;14(2):164-75. Accessed February 7, 2017.
  81. Zhao Y, Kuo TC, Weir S, et al. Healthcare costs and utilization for Medicare beneficiaries with Alzheimer’s. BMC Health Serv Res 2008 May 22;8:108. Accessed February 7, 2017.

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Page originally created June 2017
Internet Citation: Appendix B. Journal Articles Included in Literature Review. Content last reviewed June 2017. Agency for Healthcare Research and Quality, Rockville, MD.