Healthcare Cost Institute to provide data from four private sector insurers

By Molly Merrill
09:26 AM

A new health research initiative called the Health Care Cost Institute was launched Tuesday, providing researchers and policymakers access to medical claims data from four major insurers and the federal government in order to offer new insights into healthcare costs, utilization and intensity.

Officials said the new tool will inform the public policy process and assist in developing new solutions to long-term problems confronting the healthcare system.
 
Led by Professor Martin Gaynor of Carnegie Mellon University, HCCI is an objective, independent and nonprofit entity that both provides researchers with access to comprehensive data sets of commercial costs and utilization, and conducts its own research. Beginning in 2012, HCCI plans to publish its own “scorecards” and supporting analysis on aggregate trends of healthcare cost and utilization.
 
HCCI will provide access to de-identified data from plans operated by Aetna, <a href="/directory/humana" target="_blank" class="directory-item-link">Humana, Kaiser Permanente and UnitedHealthcare, as well as some government data from Medicare Fee For Service and Medicare Advantage activity. These data will include more than 5 billion medical claim records representing more than $1 trillion of healthcare activity from over 5,000 hospitals and 1 million service providers from calendar year 2000 through the present. The commercial data will also be updated regularly to ensure its usefulness for research purposes.

“Researchers and experts are clamoring for better data and deeper analysis to better understand the factors driving costs and to inform effective policy decisions,” said Gaynor, the E.J. Barone professor of Economics and Health Policy at the Heinz College at Carnegie Mellon University and the chairman of HCCI Governing Board.

“Unfortunately, the existing public data derived from Medicare and Medicaid activity aren’t enough to form a complete, up-to-date picture of national cost drivers and trends," he added. "HCCI will provide, for the first time, researchers access to data that covers all ages and health issues and is national in scope. Perhaps most importantly, for the first time there will be comprehensive data on the privately insured who make up the majority of health consumers in the United States.”

Data will be de-identified in accordance with HIPAA requirements. The Institute will establish a Data Integrity Committee whose primary focus will be on all matters related to data privacy, security and integrity. This will include the establishment of Data Contribution Agreements between HCCI and organizations supplying data to ensure data are de-identified in compliance with HIPAA and other legal and regulatory requirements. The Institute will also establish data use agreements with all researchers that will define specific parameters to ensure compliance with HIPAA regulations and other applicable laws.

HCCI’s governing board plans to broaden the list of participating health plans and add more data from government payers, including Medicaid.
 
“Because a better understanding of health spending and services can improve the quality of care and save money, the data provided through HCCI can help everyone use health resources more effectively and efficiently – to enhance both our personal health and our nation’s fiscal wellbeing,” said Harvey Fineberg, president of the Institute of Medicine and External advisor to HCCI’s Governing Board.
 
“Many actuaries agree that healthcare costs are on an unsustainable path, and the need to study the underlying drivers of costs is more important than ever,” added Society of Actuaries President Donald J. Segal. “The Institute will enable objective and unbiased research to quantify these drivers, and hopefully lead to solutions to the cost crisis.”
 
The Institute’s governing board will be controlled by independent national physician leaders and academic researchers. The board will put in place proper procedures to ensure the integrity of the Institute’s work. Likewise, the universities where the research will take place will have clear protocols to ensure the integrity of their academic output. Data contributors will continue to meet relevant legal requirements associated with data sharing and usage, including applicable HIPAA and antitrust standards.

HCCI will provide access to accredited researchers whose proposals meet HCCI’s data and scientific usage standards.

Click on the next page to read about the HCCI Governing Board.