Issue Briefs | Mar 25, 2019

Leveraging Multi-Payer Claims Databases for Value

Erin Taylor and Michael Bailit, Bailit Health

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 webinar on 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


Expert Perspectives

May 24, 2023

State Dashboards to Monitor the Unwinding of the Medicaid Continuous Coverage Requirement

The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act, with significant health equity implications. Given the intense focus on coverage transitions during the unwinding, some states have initiated plans to publish a data dashboard to monitor progress. To date, the District of Columbia and 15 states have published unwinding data in a visual dashboard format (this does not include states with pre-existing enrollment dashboards that don’t specifically identify unwinding cohorts). This expert perspective now includes an interactive map with the links to all the dashboards and states publishing CMS unwinding reports. SHVS will continue to update the EP and map as more states publish their unwinding data.

May 12, 2023

Sequencing Communications to Encourage Coverage Transitions

The unwinding of the Medicaid continuous coverage requirement represents the largest nationwide coverage transition since the Affordable Care Act. This presents State-Based Marketplaces with an opportunity to target outreach efforts to those audiences who have recently lost Medicaid or CHIP to help eligible individuals retain access to affordable healthcare through the Marketplace. This expert perspective focuses on best practices for timing and strategy in consumer outreach to consumers that are no longer eligible for Medicaid to help states develop a consumer “chase campaign.”