245561 Multi-payer claims database for comparative effectiveness research

Tuesday, November 1, 2011: 9:30 AM

Paul Wallace , Center for Comparative Effectiveness Research, The Lewin Group, Falls Church, VA
Clifford Goodman, PhD , Center for Comparative Effectiveness Research, The Lewin Group, Falls Church, VA
Amol Navathe, MD , Assistant Secretary for Planning and Evaluation, Washington, DC
Background: In its Report to The President and The Congress (2009), the Federal Coordinating Council for Comparative Effectiveness Research provided a strategic framework for national investment in CER, including development of a robust longitudinal claims data infrastructure to support CER, i.e., a “multi-payer claims database” (MPCD).

Objective: The objective of this effort is to develop a MPCD that will support analyses involving priority populations, priority intervention types, and a range of conditions, e.g., those among the 100 priority CER topics identified by the Institute of Medicine (IOM).

Methods: The MPCD is being implemented over three years by Ingenix under contract to CMS and guided by OASPE, HHS. The project team includes The Lewin Group and several subcontractors, including AcademyHealth, Buccaneer Computer Systems and Services, and The University of Washington. The MPCD will be a hybrid data resource, incorporating a central warehouse and a decentralized, “Virtual Hippocratic” database enabling privacy and use constraints determined by contributing data partners and data aggregation across sources. It will be accessible to researchers, policymakers, and other stakeholders. Among its required attributes are: national-level public and private sector payer data; large representative sample of the U.S. population including underserved populations; information for understanding practice variation; statistical power for hypothesis testing for subpopulations or health care interventions not feasible in other databases; and a platform for clinical data enhancements (e.g., electronic health records).

Results: Research findings will be generated when the MPCD is developed and tested. Researchers at The University of Washington will conduct initial analyses to validate the MPCD based on selected IOM national CER priority topics.

Discussion: Pursuant to the intent of ARRA to strengthen the national infrastructure for CER, the MPCD will provide a state-of-the-art resource for using claims and other observational data to support CER.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Public health or related research

Learning Objectives:
Define a multi-payer claims database (MPCD). Define the role of the MPCD in the national CER initiative. Describe at least three main attributes of the MPCD and its incremental value to researchers.

Keywords: Outcomes Research, Health Insurance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee programs utilizing multi-source claims data for analysis, quality improvement and research.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
The Lewin Group, An OptumInsight Company Comparative Effectiveness Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.