The Journal of the Arkansas Medical Society Issue 3 Vol 115 | Page 8
According to ACHI, the mission
of the APCD here in Arkansas
is to be a trusted and timely
source of information that
could help improve health care
quality and delivery, lower
costs, and more.
where our health care dollars are going and why.
“The American health care system is the most
expensive in the world, yet by most indicators it
is one of the least effective,” said Dr. Thompson.
“As consumers and providers begin to absorb
more of the financial responsibility for care, they
will increasingly demand information on how
much things cost and where dollars are being
spent. The APCD is one mechanism to unlock the
‘black box’ of insurance payments and open the
window of transparency. Indeed, many states
have used data from their claims databases to
build health care transparency websites that al-
low consumers to compare outcomes and costs
for certain procedures.”
Examples of such state-based comparison
sites include Maine (comparemaine.org) and
Minnesota (mnhealthscores.org).
A recent report by the Catalyst for Pay-
ment Reform shows Arkansas receiving an “F”
on statewide transparency laws and efforts.
The Arkansas APCD is a big step in changing
that low grade in that it makes price and quality
information more readily available to providers,
policymakers, researchers, and individual and
business consumers and thus supports more
informed decision-making.
For Use By …
The Arkansas APCD is available to individu-
als and entities alike, and data release requests**
show that its information is being utilized for
varied purposes by consumers, providers, re-
searchers, policymakers, and other parties.
Bradley Martin, Pharm.D., Ph.D., professor
of Pharmaceutical Evaluation and Policy at UAMS
College of Pharmacy, is the principal investiga-
tor in a research project made possible by the
APCD. Funded through a grant from UAMS’s
Translational Research Institute, his analyses
project is entitled, “Care Decisions and the Risk
of Long-Term Opioid Use in Patients with Low
Back Pain.”
“Our interest is in identifying potentially
modifiable factors such as how opioids are
prescribed and other management decisions
including physical therapy made at the time of
opioid initiation,” said Martin. “Improved deci-
sion-making around these modifiable factors
at the initiation of care may provide the best
opportunity to prevent long-term use. In this pi-
lot project, we take a crucial step towards our
goal by examining data from two state-wide all-
payer claims databases – Arkansas and Utah.
Both have higher than average rates of opioid
prescribing. The results of our study are not ex-
pected until May of 2019.”
Another ongoing use of the database cen-
ters on medical marijuana. For this analysis be-
ing done by ACHI, data is being pulled to examine
the profiles of individuals registered for medical
marijuana using medical claims from 2013-
2016. The APCD profiles registrants by qualify-
ing medical condition, insurance type, and age.
A recent case study served as a preliminary look
at the characteristics of individuals registered for
medical marijuana in Arkansas and found that,
for example, the most common condition seen
in those individuals was disease of the musculo-
skeletal system and connective tissue (arthritis).
… Physicians
A quick scan of those requesting data
from the APCD showed few physicians; still,
Dr. Thompson indicated that the database can
serve as a rich resource for physicians and other
care providers. “Individual physicians and other
providers may need assistance with producing
meaningful information from the APCD data it-
self, but analyses of the data can yield a wealth
of information valuable to physicians,” he ex-
plained.
He shared insights physicians might glean
from analyses of APCD data, including a better
understanding of patients’ utilization and cost of
services outside their clinics; an idea of quality
and cost of providers to whom they refer patients
56 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY
(to help patients get better value and outcomes),
and information to help those selecting account-
able care partners.
“Providers could use the APCD to better
understand the differences in payment rates
and reimbursement times from different health
insurance providers,” continued Dr. Thompson.
“The APCD could also be used to provide a
consolidated report documenting performance
across payers so that providers have one source
for examining or defending their practice’s pro-
files.”
Looking to the future, ACHI expects that pro-
viders could look at referral sources—hospitals,
specialists, therapists—for insight into not only
the quality of care but also utilization profiles
and health outcomes. “This would be similar to
episodes of care now,” said Dr. Thompson, “but
with information enabling providers with finan-
cial risk to better select their referral providers.
“Providers could use the APCD to bench-
mark for value-based performance indicators
and assure appropriate treatment under new
risk-bearing payment models. Data from the
APCD can also support efforts in the Choosing
Wisely campaign to try and identify unnecessary
tests and services and gaps in appropriate care
to help improve the effectiveness and efficiency
of the healthcare system.
“Finally, it is important for the physician
community to help guide and to use this new
source of information. As our Arkansas health
care system gets reshaped by public and pri-
vate payers, tracking the dollars to ensure our
patients continue to get the care they need will
be paramount, and this new tool to pull back the
curtain on payment is critical.”
For more examples of how Arkansas
APCD data is being used, visit the APCD
Council’s Showcase at apcdshowcase.org/
case-studies. For more information and an-
swers to frequently asked questions, call the
Arkansas All-Payer Claims Database Team
at 501-526-2244 (8 a.m.-4:30 p.m., Monday-
Friday).
*press date July 20, 2018
**https://www.arkansasapcd.net/Resources/
DataReleaseRequests
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