Medical claims database could aid research on best treatments

The HHS database could include medical claims from all payors nationwide

The Health and Human Services Department wants to create a new national database of medical claims for all payors to assist in its comparative effectiveness research.

The HHS Office of the Assistant Secretary for Planning and Evaluation is seeking a vendor that can design such a database that would collect data from Medicare, Medicaid, state and local agencies and private insurers, according to a Dec. 15 notice on the Federal Business Opportunities Web site.

The project is being paid for with funding from the economic stimulus law, which provides $1.1 billion for comparative effectiveness research. In traditional research, scientists evaluate the effectiveness of a single medication or course of treatment. In comparative effectiveness research, two or more treatments are compared to see which is more effective.

The goal is to form a robust database of claims data over time to facilitate analysis. Currently, the Centers for Medicare and Medicaid Services collects claims data, but only for Medicare and Medicaid populations. States have all-payor databases, but they are limited in scope. Private entities also have some applicable databases for diverse populations but they may be fragmented and expensive to access, states the notice.

“An all-payor, all-claims database would allow for greater power in analysis, ensuring that the data infrastructure the Secretary supports will be able to produce robust analysis. If developed well, this database would be a representative sample of the population and could be built upon over time,” the notice states.

A related objective is that the claims database could be linked to other databases in the future, such as clinical data, for work on improving health care outcomes and quality, the notice said. Typically, since claims data is designed for payors, it does not include all appropriate clinical information needed for research to improve health care outcomes and quality. That is why a link to clinical data may be needed for future research in those areas.

David Blumenthal, HHS national coordinator for health IT, spoke recently of his goal in developing a learning health infrastructure of clinical health data to evaluate quality and outcomes on an ongoing basis.

About the Author

Alice Lipowicz is a staff writer covering government 2.0, homeland security and other IT policies for Federal Computer Week.


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