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FHC President pens Op-Ed promoting use of state APCD data for vaccine rollout

President, Freedman HealthCare, LLC

John, principal of Freedman HealthCare LLC, has 25 years of experience in performance measurement & improvement, health IT, care delivery, and health care reform. At FHC he has helped many states create all-payer claims databases, implement health insurance exchanges, and support health care transformation.

This weekend, Freedman HealthCare CEO, John Freedman, published an Op-Ed in MedPage Today discussing how state’s all-payer claims databases (APCDs) can help policymakers target COVID-19 vaccine distribution.

Our nation recently marked one year since the World Health Organization declared COVID-19 a pandemic. President Biden marked the anniversary by announcing an accelerated pace for getting the nation vaccinated with a goal of making every adult in the U.S. eligible for vaccination no later than May 1.

As part of the national strategy, the administration is planning to help community health centers reach at-risk and underserved communities, including low-income and minority patients, as well as rural and tribal communities.

This strategy is predicated on being able to identify communities and geographic areas where there are concentrations of people whose age or comorbidities make them more likely to experience severe COVID-19 outcomes.

One tool to consider in the arsenal of identifying at-risk patients is the use of all-payer claims databases (APCDs). APCDs are state databases that collect and aggregate healthcare claims from public and private payer sources, including Medicare, Medicaid, and private insurers. The data is culled from medical claims, pharmacy claims, dental claims, and eligibility and provider files and can be used to examine market dynamics and compare costs across counties and states. Increasingly, policymakers are finding this data is essential to understanding trends in healthcare.

APCD data about state residents’ health status can help policymakers geotarget regions by zip code, age, diagnoses, and medication history. The availability of all these data within a single source makes APCDs a rich source of information to better understand which communities within a state may be most likely to experience higher rates of severe illness and therefore should be prioritized for vaccine distribution.

Some states have already taken steps to take advantage of this resource to inform their COVID-19 response planning and vaccination schedule. For example, using data from their APCD, Colorado state health officials and analysts from the Center for Improving Value in Health Care (CIVHC) used CDC risk criteria, including patient’s age, presence of chronic health conditions, and status of living in a nursing or long-term care facility to develop a geographic dashboard that helped inform their vaccine schedule.

As Kristin Paulson, JD, MPH, Chief Operating Officer at CIVHC noted, “This new interactive dashboard allows detailed examination of where and how many at-risk Coloradans there are. Public health authorities can use this information to plan vaccine distribution logistics, to help ensure enough vaccine gets to the highest priority citizens around the state.”

Utah’s Department of Health used APCD data in response to a request by the Utah Health Data Committee to track COVID-19 healthcare trends across the state, producing quarterly reports on telehealth visits, including those for mental health services, rate of vaccinations, and emergency department visits to help better understand healthcare consumption trends.

Currently, 25 states (Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Indiana, Kansas, Maine, Maryland, Massachusetts, Minnesota, Nebraska, New Hampshire, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont, Virginia, Washington, and West Virginia) have legislation that mandates APCDs, and several more are exploring establishment of an APCD.

In October 2021, the federal government is releasing up to $2.5 million in grant funding per state to help states launch or expand their APCDs. Every state is eligible for this amount, which can jumpstart or accelerate the work underway.

Throughout the last year, APCDs have proven to be a valuable tool in tracking the impact of the pandemic, from identifying those at risk to tracking deferred medical services to planning vaccine distribution and prioritization.

As our nation works to emerge from the pandemic, APCDs are crucial to understanding the long-term impact and implications of COVID-19 on healthcare outcomes, treatments, and costs, as we navigate our new normal around this and future pandemics. By starting now, states can prepare for the future while taking advantage of federal help to get there faster.

Op-Ed originally published in MedPage Today on April 3rd, 2021. Find the original article here.

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Want to learn more about how states around the country are using their APCDs to achieve better health outcomes in their communities? Check out our website and find our solutions here.

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