Highly anticipated All Payer Claims Database launches
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The Indiana Department of Insurance announced the launch of the Indiana All Payer Claims Database website Monday, a highly anticipated legislative effort to provide transparency to health care costs and allow consumers to compare prices across multiple health systems.
“The Indiana All Payer Claims Database website will provide valuable insights into healthcare costs, quality, and utilization patterns across our state. By making this data accessible, the APCD website will be an invaluable tool in driving data-based decisions, and ultimately enhance the well-being of Indiana residents,” said IDOI Commissioner Amy L. Beard in the release.
By entering their insurance and zip code, the interactive tool helps users to compare prices — including out-of-pocket costs — and quality ratings for various procedures, such as knee replacements. IDOI tasked Onpoint Health Data in a four-year, $8.2 million contract to design and maintain the APCD starting Jan. 1, 2023 and ending in 2026.
“Our partnership with Onpoint marks a significant milestone in advancing our data management capabilities. We’re confident that this collaboration will enhance our ability to deliver innovative data insights that will benefit our stakeholders across the state,” said Jonathan Handsborough, executive director of the effort.
Onpoint developed the first-of-its-kind APCD for Maine in 2003 and has developed more than half of the current APCDs in the United States.
The release continued to say what a benefit the database could be for employers and policy makers, saying the information could “strengthen their decision making about benefit design and network optimization for employees.”
“Additionally, researchers and policy makers can study healthcare utilization and cost trends by service type and location across the state,” the release continued.
Various payer sources — including insurers, health maintenance organizations, pharmacy benefit managers and others — contributed to the database, which was a priority of Gov. Eric Holcomb and passed the legislature in 2020. Entities that don’t contribute could be subject to a civil penalty, which will start at $100 per day, per violation for the first 30 days before increasing to $1,000 per day, per violation.
However, legislators have previously expressed caution about the impact of the legislation, openly wondering if it will convince consumers to make a different choice. Sen. Ed Charbonneau, R-Valparaiso, noted that patients usually only pay attention to their out-of-pocket cost for the nearest facilities, rather than the cheapest, highest-quality procedure for their insurance policy or employers.
“If I have insurance, I’m not going to pay that much attention to cost,” he said last August during an APCD update. “If I have a hospital that I have right in the area, that’s convenient … I’m going to go there.”