By John Reichard, CQ HealthBeat Editor
September 20, 2011 -- To what degree do prices, not the volume of health care services, account for rising health costs? To what extent do Medicare cuts cause hospitals and doctors to charge more to private insurers, leading them to increase premiums?
Those are two of the questions analysts hope to be able to answer with the launch of a first-ever huge research database of private insurance claims.
The new Health Care Cost Institute will house data from plans operated by Aetna, Humana, Kaiser Permanente and United Healthcare, as well as some Medicare data, including data about Medicare Advantage, the private health plans in Medicare.
At first the database will include about five billion medical-claim records representing more than $1 trillion in health spending. The claims relate to services provided by some 5,000 hospitals and 1 million other providers. The institute, which is led by a board consisting largely of academic researchers and says it is nonprofit and nonpartisan, will try to bring in data from other private insurers as well.
"Researchers and experts are clamoring for better data and deeper analysis to better understand the factors driving costs and to inform effective policy decisions," Martin Gaynor, a professor at Carnegie Mellon University and the institute's chairman of the board, said in a statement announcing the initiative.
"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 said. "HCCI will provide, for the first time, researchers access to data that covers all ages and health issues and is national in scope," Perhaps more 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."
The institute will limit access to the data, which includes claims from 2000 to the present, to researchers. The claims will be stripped of patient identifiers. Plans call for issuing research findings in the form of "score cards," twice yearly starting in 2012. According to the institute's mission statement, the score cards "will contain timely information on aggregate trends for health care costs for commercial payers, the most recent data available for fee for service government payers, and will break out trends in inpatient hospital spending by unit prices for services, number of admissions, and intensity of admission."
In addition, "these reports will include cost trend data at a national aggregate level, with additional geographic information available over four or five regions. Data provided in the score cards will be freely available online to the public, with access provided to more detailed background data tables that will be available for download."
