Use of all-payer claims database (APCD) data to fully inform public health

Background: State governments recognize their need for information about population health across many areas – health status, health care utilization, access, quality, and costs – in order to identify opportunities to improve the public's health. This understanding requires the availability of high-quality data. Though common administrative datasets provide a suite of population-based information about patient demographics, diagnoses, procedures, and usage of hospital services, information on outpatient utilization, costs for care, pharmacy utilization, and other information is often lacking. One way states have responded to gaps is by developing all-payer claims databases (APCDs). APCDs combine claims data from multiple payers in a state, providing data about population health that aren't available in other data. Objective: To demonstrate the synergy of currently available public health data and emerging APCD data, and discuss how linkage of these datasets could help fully inform population health. Methods: Demonstration of the contents of APCDs, describing the use cases of existing state APCDs, and explaining the utility of APCDs to better inform public health. Results: States are leveraging claims systems to understand dimensions of population health that are not understood from other public health datasets. Public health programs are recognizing the ability to use claims data to understand where opportunities exist for public health services for secondary and tertiary prevention (for example, promoting lipid screening for cardiovascular disease). Claims data's inclusion of payment information also helps states understand how health care costs can be impacted by preventing disease, or impacting disease severity. States are also collaborating to explore issues with access to care, and understanding how far people travel for which kinds of services. Discussion: Administrative public health datasets have long been powerful tools for understanding the health care system and the public's health. APCDs are an emerging dataset that fill gaps about information typically not available.