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David_morales Posted by: David Morales, Commissioner, Division of Health Care Finance and Policy

Last week, I wrote about regulatory hearings the Division will hold to discuss the "APCD," also known as an all-payer claims database. Today I want to highlight 2 important ways in which the APCD may help us change the way we as consumers understand, use, and pay for our care.

We all know that health care spending is rising, but did you know that spending on health care in Massachusetts is 15% higher than the rest of the country, on average?  While it is true that we need to invest money to continually improve our health care system, if annual increases in health care spending continue at unsustainable rates, it could harm growth in other areas of our economy.

Data shows us that employers are facing higher increases in premiums and have fewer dollars to spend on wages and new jobs. In addition, people with employer-sponsored health insurance are paying more for their health care through copayments, deductibles, and premiums.  Even with these increases in health care spending, we as consumers have limited information regarding the actual cost of medical services or the quality of care provided at specific hospitals. 

We intend to use the APCD as an important transparency tool about how and where we spend our health care dollars.  Specifically, we will publicly shine a light on trends in medical spending and utilization, as well as differences in payments made by health insurers to hospitals for the same service by provider and geographic areas of the State. 

We also plan to use the APCD to shed light on the quality of care delivered at specific institutions.  In health care—like with many goods and services—there is a general perception that the more you pay, the better quality you get.  But as with everything else, this notion is not always the case.  Through the APCD we hope to be able to compare performance based on quality and cost indicators for hospitals, provider groups, and integrated systems of care. 

If done right, data-driven analyses will help to change how we use care and help us develop a delivery system that ensures that people in Massachusetts receive the right care, at the right time and at a reasonable cost.

Today, you have the opportunity to provide your testimony regarding this important initiative. The Division is holding public hearings relative to the creation of an all-payer claims database (under the adoption of regulation 114.5 CMR 21.00: Health Care Claims Data Submission) at 10:00 a.m. and to the release of this data (114.5 CMR 22.00 Health Care Claims Release) at 1:00 p.m.  The hearings will be held at 2 Boylston St, 5th Floor, Boston, Massachusetts.  Written testimony can also be submitted to the Division through May 28. 

I look forward to seeing you there.

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