The Journal of the Arkansas Medical Society Issue 3 Vol 115 | Page 6

by CASEY L. PENN
All-Payer Claims Database
A Largely Untapped Resource for Physicians
T
his digital age we’re living in
has left much of our personal
lives open to voyeurism. As phy-
sicians and other AMS-member health care pro-
viders, you may feel a bit professionally vulner-
able as well – like every patient conversation,
every prescription given, every choice you make
may be recorded and potentially accessible.
While we are all personally and profession-
ally vulnerable to data collection and associated
scrutiny, it’s possible that these collections could
also offer helpful information. If your actions as a
physician are to be subjected to data collection,
shouldn’t you also benefit from it? For example,
what if you could use some of this data for the
good of your patients and your clinic?
A relatively new source of data collection is
making this possible here in Arkansas.
The Arkansas Center for Health Improve-
ment, in partnership with Arkansas Insurance De-
partment, has developed the Arkansas All-Payer
Claims Database, a storehouse, if you will, of per-
tinent health care information. Operational since
2016, it contains information dating back to 2013.
Arkansas is among 20 states to develop
such a database. Now that it is up and running,
AMS wants physicians to be aware of the value it
may hold for them specifically. “The claims from
all the different insurance carriers in the state
go into this database,” explained AMS Executive
Vice President David Wroten. “Physicians may be
able to utilize this available data in many ways
… for example, a physician could use the data-
base to determine the average billed charge for
a knee replacement and/or the average amount
paid by insurers for that knee replacement.”
APCD – The Basics
The APCD is administered by ACHI and over-
seen by the Health Insurance Rate Review Divi-
sion, a division of the AID. The APCD receives ad-
visory input from the Arkansas Healthcare Trans-
parency Initiative Board. This board is the result
of legislation that supported and established the
APCD, namely, the Arkansas Healthcare Trans-
parency Initiative Act 1233 of 2015.
The Act mandated that public and private
payers submit health care data to the APCD and
established the purposes for which APCD data
may be used.
Kenley Money, director of information systems architecture for the Arkansas Center
for Health Improvement, works on a plan for checking data quality in response to a
request for data.
54 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY
Original data elements that payers were re-
quired to submit included medical, dental, and
pharmaceutical claims; enrollment files; and
provider files. Act 948 of 2017 added medical
marijuana registry data as a new element to the
APCD. Act 979 of 2017 added hospital discharge
and emergency department records for the un-
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