All Payer Claim Database
A new and comprehensive database of healthcare claims paid in the state of Georgia will help identify disease trends, provide information for making public policy decisions, facilitate new research – and offer a way for consumers to determine the average cost of common procedures such as knee replacement or diagnostic testing such as MRIs.
Administered by GTRI’s Health Emerging and Advanced Technologies Division (HEAT-D) the Georgia All-Payer Claims Database (GAPCD) will move Georgia into the ranks of more than two dozen states that provide such a pathway to healthcare cost and quality transparency. Scheduled to launch officially by January 2023, the GAPCD will include de-identified data from patients and most public and large private payers of healthcare costs.
In other states, similar systems have provided crucial insights into the health of state residents and helped guide efforts aimed at reducing tobacco or opioid use and battling specific health issues. The database may also generate research that informs the state’s healthcare professionals in selecting the best treatments for Georgians dealing with such common problems as high blood pressure or lower back pain.
Beyond the policy and treatment issues, the GAPCD will help provide information for consumers considering elective procedures such as knee or hip replacement, and common diagnostic tests such as MRIs and CT scans. It will also provide a measure of the outcomes from procedures to help patients and healthcare professionals determine, for example, whether medication or physical therapy might be the best approach to addressing a specific condition. For university researchers, the database will provide a new source of data on the health of millions of Georgia citizens.
The GAPCD was created by the Georgia General Assembly in 2020. The legislation mandated an advisory council composed of healthcare providers, insurance companies, legislators, state health agencies and other stakeholders with an interest in its operation.
Health insurance companies and other payers will be contributing data to the system. Identifying information will be removed from the data and security protocols will be put into place to protect patient privacy. GTRI already has extensive experience with cybersecurity, and has put together large information systems for the Georgia Department of Community Health, U.S. Department of Defense, national law enforcement agencies and other state and national organizations.