Health Care Cost Database

1. Health Care Cost Database Presented by the Office of the Commissioner of Securities and Insurance January 2011

2. The Office of the Commissioner of Securities and Insurance, Montana State Auditor, is a criminal justice agency whose primary mission is to protect Montana's consumers through insurance and securities regulation. We work hard everyday to educate and assist the public about the wide range of issues in insurance and securities. We are committed to ensuring fairness, transparency and access in the securities and insurance industries.

3. Overview • lack of information about the wide-ranging costs of medical services is one of the biggest obstacles to bringing down the cost of health insurance • Compiling data about the cost of health care across the state can help insurers, businesses, and better understand where health care dollars are spent • Reliable information helps develop initiatives to make health care spending more efficient.

4. Overview • Several states have set up databases that collect health insurance claims information • Often called "all-payer, all-claims" databases, they are designed to improve transparency in health care • Data can produce direct cost comparisons across communities, treatment methods, and outcomes • All information collected in the health cost database is anonymous

5. Benefits of a statewide health care cost database include: • Allows state policymakers to monitor the success and efficiency of efforts to reduce health care costs and improve both health care quality and population health • Shows statewide variation in care, including whether evidence-based guidelines and best-practice clinical standards are being followed and how they affect cost and quality • Helps businesses to learn where they stand when compared to their peers with respect to the cost and covered services of health insurance policies

6. Benefits of a statewide health care cost database include: • Provides consumers with information that they and their health care providers can use to make informed decisions about the effectiveness of treatments • Supports providers' efforts to design targeted quality improvement initiatives and to compare their own performance with that of their peers • Helps health care policymakers identify communities that provide cost-effective care and evaluate reform efforts so successful initiatives can be identified and replicated

7. Study Bill • Montana’s legislature passed HB 573, a bill to study how to build a statewide database to track health care costs and identify ways to cut costs while improving quality of care • The CSI leads the study with an advisory council of medical providers, patient advocates, insurance experts, and policymakers • The council will review the costs, benefits, and procedural and technical requirements necessary to design, implement, and maintain a statewide health care cost database for Montana.

8. The Health Care Cost Database Advisory Council will fulfill the following tasks: • Furnish advice on setting up specific strategies to measure and collect data related to health care safety and quality, utilization, health outcomes, and cost • Recommend data elements that foster quality improvements and peer group comparisons • Recommend usable and comparable information that allows public and private health care purchasers, consumers, and data analysts to identify and compare health plans, health insurers, health care facilities, and health care providers

9. The Health Care Cost Database Advisory Council will fulfill the following tasks: • Recommend the elements necessary to measure safety, timeliness, effectiveness, efficiency, equity, privacy, and patient-centered approaches • Recommend the data regarding claims, eligibility requirements, and other publicly available data that may be used to minimize the cost and administrative burden of collecting data • Recommend any other relevant health care information for the creation of a statewide health care cost database.

10. Council Activity • The first meeting took place in December 2011 • The council elected Representative Chuck Hunter as Council Chair • Database pilot project presentations demonstrating the feasibility for Montana and a draft study plan were presented to the council for discussion.

11. Council Activity • The council decided on an initial plan to research information from states that have already established a database • A survey to identified states was created and is currently underway • A legal research project into database has begun • The next scheduled Health Care Cost Database Advisory Council meeting will be on Monday, January 23rd at 1p.m. at the Commissioner’s office located at 840 Helena Ave., Helena.

12. Reporting The Insurance Commissioner will report by August 1, 2012, to the Children, Families, Health, and Human Services Interim Committee on the results of the advisory council's review and any recommendations for action by the 63rd legislature.

13. For More Information: Visit csi.mt.gov If you have questions, or if you want to join the interested parties list, contact: Christa McClure406.444.4328cmcclure@mt.gov