Utah all payer database apd
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Utah All Payer Database (APD). Introduction to the Reporting Capabilities of the Utah All Payer Database Mark Gaskill, MFT [email protected] Keely Cofrin Allen, PhD [email protected] Utah Department of Health Office of Health Care Statistics. History.

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Utah All Payer Database (APD)

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Utah all payer database apd

Utah All Payer Database(APD)

Introduction to the Reporting Capabilities of the

Utah All Payer Database

Mark Gaskill, MFT

[email protected]

Keely Cofrin Allen, PhD

[email protected]

Utah Department of Health

Office of Health Care Statistics


History

History

On July 8, 2008 the Utah Health Data Committee unanimously approved a health data plan outlining the creation of an APD.

Funding for the APD was provided via House Bill 133, Health Care Reform (2008). The Utah Department of Health (UDOH), Office of Health Care Statistics (OHCS) is responsible for building and managing the APD.

Other states have APDs; however, Utah is now the first state in the country to have an All Payer Database that can analyze episodes of care (EOC) derived from statewide – cross payer – health insurance claims.


The utah apd now provides the capability of reporting

The Utah APD now provides the capability of reporting:

  • Medically, what happened? (by EOC)

  • When and where did it happen?

  • How much did it cost?

  • Greater Degrees of

  • Healthcare

  • Transparency

  • Who paid for what (including healthcare consumer out of pocket costs)?

  • Which costs were not covered? (including denied claims)

  • What other influences impact outcome (disease burden, co-morbidities, demographics, environmental issues, access to specialists, etc.)?

  • What impact does preventive care or lack there of, have on outcome?

  • Were relevant standards of care met?

  • How do healthcare consumers migrate between commercial plans; between commercial and public plans?


Where the utah apd stands today

Where the Utah APD Stands Today:

  • $1,847,869,396 - Utah Health Care Dollars Represented in the Utah APD

  • 1,079,270 - Unique Utah lives identified, linked and grouped

  • 48,567,000- Medical Claims processed and parsed in the APP primary data warehouse

  • 67,989,000 - Pharmacy Claims process and parsed in the APD primary data warehouse

  • Second Phase Pilot will be competed February 2010 (initial APD reporting will commence during Second Phase Pilot);

  • Third Phase Pilot Completed Summer 2010 (APD fully operational)


Utah all payer database apd

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Top Ten Diseases Driving Cost

Analysis Period Ending: 2008-12

* Unique members with the disease

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Top Five Conditions Driving Cost

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Top Ten Therapeutic Classes by Volume

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Top Ten Therapeutic Classes by Cost

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Pharmacy Statistics

Top Twenty Drugs by Cost - Retail

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Generic Utilization Total Prescriptions

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Health Status and Cost Drivers

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Average PMPM Distribution by Health Status

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Member Distribution and BOI by Demographics and Age

Sample Data

For discussion and demonstration purposes only


Utah all payer database apd

Top Twenty-Five Drugs by Volume - Retail

Sample Data

For discussion and demonstration purposes only


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