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Best practices for launching and operating an all-payor claims database

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By Al Prysunka | 17 August 2012

The high and sustained growth rate of healthcare in the United States over the past two decades has created significant financial pressures for both government payors (Medicare/Medicaid/VA) and private sector employers who offer health insurance to their employees. Additionally, while per capita healthcare expenditures have increased at an alarming rate, many believe that the overall quality of healthcare in the United States is not commensurate with the expenditures and that significant improvements in health outcomes for the general populace have not been realized.

In order to address the cost and quality issues in the U.S. healthcare system, both government policy makers and employers have found it critical that a comprehensive and timely source of data be available to better define the problems and to set forth proposed solutions. The data set that has emerged to meet those requirements is the all-payor claims database (APCD). This paper will provide an overview of the structure and key considerations for planning, launching, and operating an APCD, and will list a number of potential uses for the data, once collected.