Texas Employers for Affordable Health Care (TXEAHC), a non-profit tasked with lowering the cost of health care for employers and families, applauds the funding of the Texas All-Payor Claims Database.
The Texas 89th Legislature’s approval to fund UTHealth Houston’s budget request to fully establish and maintain the database and public access portal, will allow the Center for Health Care Data to conduct the research necessary to produce required reports on health care pricing, resource use, and quality information for policy makers, purchasers, and consumers. A funded APCD also allows other qualified researchers to conduct research that could improve the cost, quality, and delivery of health care in Texas.
“Transparent pricing is an essential part of any healthy market and it has long been absent when it comes to health care,” said Chris Skisak, PhD, executive director for TXEAHC. “Many health plans lack the data necessary to put together benefit plans that can lower prices and improve the value of care. The result is that too many employers are paying what are sometimes exorbitantly high prices for health care, undermining their ability to hire new workers or pay better wages.”
A funded Texas All-Payer Claims Database with non-personally identifiable health care claims data from public and private payers will help remove some of the mystery around health care prices, eliminating a significant barrier to use. A poll by Texas 2036 found that 41% of likely Texas voters had someone in their household postpone or skip medical treatment in recent years because they didn’t know what the final medical expense might be, and that number went up to 52% for mothers.
The data provided by a Texas All-Payer Claims Database can also be used by employers to benchmark their plans against others, identifying low-priced providers that can actually be utilized—because the database contains actual claims data, it indicates which providers are actually providing specific services regularly.
Establishing baseline health care pricing information allows allow employers to monitor and analyze health care expenses and outcomes, using that data to identify high-value providers, and improve health benefit plans in ways that reduce expenses while improving quality of care.
A Texas All-Payer Claims Database will also provide state officials with actionable information that could be used to better design high-value benefit plans for state employees, assess population health, measure utilization of health care services, and review the cost of government health care mandates. It will also help enable oversight of health insurance premium medical loss ratios, as well as waste, fraud, and abuse studies that could lower health care expenses for state agencies.