Translating Research into Policy: How Claims Data Can Help Shape Public Policy on Healthcare and Assess Its Impact

Healthcare claims data can be instrumental in examining critical healthcare policy issues, helping to inform policy making and facilitate decision making at the state and federal levels. Such data can also be used to assess the effects of enacted policies over time. Drawing on data from our database of over 28 billion privately billed healthcare claims, this session will present several use cases related to pressing issues in US healthcare policy. Examples will include: Surprise Medical Bills. Many states are considering or have enacted legislation protecting consumers from balance billing and “surprise” medical bills. We will discuss how benchmark cost data based on private healthcare claims have informed consideration and enactment of legislative solutions in a number of states. We will address the variety of ways in which states may calculate reimbursement standards, showing how claims data from a conflict-free, independent source have often been found suitable as a reference point for consumer protection legislation. Opioid epidemic. We will showcase results from the most recent of our four white papers on the opioid epidemic, revealing how US regions and states differ greatly in the medical procedures they are using to address opioid abuse and dependence. We will also present our analysis of the effects of a 2010 Illinois law that increased access to naloxone, a drug used to reverse opioid overdoses. Food allergies. Costs and claim lines for food allergy treatment have skyrocketed: From 2007 to 2016, claim lines for treatment of severe food allergy reactions increased by nearly 400 percent. This rising tide is placing a growing burden on patients, families and society. We will share the results of our study of food allergies and discuss the implications for health economists, policy makers and public health officials. Mental health parity law. The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 required most group health plans that cover physical and mental health to provide the same level of coverage for mental as for physical health. Now, a decade later, we investigate the impact of that legislation: Did it have the intended results? Our claims data-based analysis will reveal trends in behavioral health services utilization and diagnoses since the MHPAEA. Other use cases. We may also present use cases on the rise of telehealth and urgent care centers as healthcare delivery options, state workers' compensation programs, regional variations in regulation of such care options, and the implications for care access, delivery and further study. Robust claims data from an impartial source support health economists, policy makers, government officials and other stakeholders in formulating sound, effective healthcare policy and in evaluating the effects of enacted policy. Our presentation will highlight the ways in which claims data are well suited to policy analysis, shedding light on trends and patterns in some of the most crucial public health issues today.