Dr Karen van Caulil Explains the Benefit of an All-Payer Claims Database

A statewide all-payer claims database would permit more insight into what’s happening with cost and quality of providers, and possibly transform healthcare payment, explained Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

A statewide all-payer claims database (APCD) would permit more insight into what’s happening with cost and quality of providers, and possibly transform healthcare payment, explained Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.

Transcript (modified)

What is the benefit of a state having an All-Payer Claims Database?

Yeah, I’d really like it to be an all-payer database, not just claims but also quality data, and so that’s sort of a personal mission of mine to expand it beyond APCD to really an all-payer database. But having that information from all of the different self-funded plans, like we have with our large employers but also those who are fully insured and Medicare and Medicaid, and get it all in one place and look at a market level at what’s happening with providers with cost and quality will be very powerful in this move to transform healthcare payment. Without that information, again, we’re very siloed when we’re individual, and having obviously the legislative mandate to do that would be very, very powerful in a short period of time.

Unfortunately, there’s been a Supreme Court ruling [earlier in 2016] that self-funded plans can’t be required to submit their claims. But in Florida our employers who are self-funded understand the importance of that, and I’m encouraged by their reaction to say “we’ll participate, anyway.”