All payer claims databases (APCDs) and other multi-payer claims databases are a source of information that, when used effectively, can provide insight into how states’ health care systems are functioning and facilitate data-driven decision-making. This issue brief looks at the progress states and community organizations have made in using their APCDs or other multi-payer claims databases for various strategic purposes, and offers considerations for states that are seeking to optimize their own claims databases to achieve health care system performance improvement goals. It identifies three broad data use categories and provides a high-level description of the approaches taken by select states and one community organization, with attention to practices that may not be as widely used across states, or in areas that states and community organizations are just beginning to pursue.
The State Health Policy Highlight, Achieving Transparency and Value Using Multi-Payer Claims Databases, provides an overview of how states are leveraging their claims databases and reviews the lessons experienced states and community organizations have to offer other states seeking to optimize their own databases.
State Health and Value Strategies, in partnership with the Peterson Center on Healthcare, hosted a webinaron March 27 during which presenters from the state of Vermont and Rhode Island, as well as the Washington Health Alliance, discussed how they are employing claims databases to enhance the value of care and shared lessons learned for those seeking to optimize their own databases
Ensuring affordable health coverage and healthcare for immigrant populations in the United States is critical to advancing health equity. In a new series, State Health and Value Strategies (SHVS), with support from the Robert Wood Johnson Foundation, highlights strategies for states to expand affordable health coverage to immigrant populations in the United States. This expert perspective provides an overview of the products included in the series.
On September 8, the Department of Homeland Security (DHS) issued a final rule on the “Public Charge Ground of Inadmissibility,” regarding DHS’ authority to refuse a noncitizen’s application for admission or application for visa adjustment (including receipt of a green card) on grounds that they are “likely at any time to become a public charge.” This expert perspective provides an overview of the final rule.
This expert perspective provides an overview of the eligibility and enrollment proposed rule released by CMS on August 31 and details how the proposed rule seeks to strengthen existing eligibility, enrollment, and renewal operational processes in an effort to close gaps in coverage and extend best practices identified by CMS and states in the course of preparing for unwinding the federal public health emergency (PHE). Comments on the proposed rule are due no later than November 7, 2022.
