By Senator Linda T. “Toddy” Puller (D-36) and Delegate John M. O’Bannon, III (R-73)
The answer is “no.” The Virginia Health Reform Initiative Advisory Council (created by Governor McDonnell) stated the case for change in its 2010 report. “Virginia’s overall quality of care is average, with strengths in cardiac care, hospital care generally, and home health. Weaknesses in Virginia’s quality rankings include nursing home care, diabetes care, and maternal and child health. Specifically, Virginia ranks 41st in the nation in breast cancer death rates, and 35th in infant mortality. None of these statistics measure up to Virginia ranking sixth, nationwide, in median family income.”
As health care costs continue to take a larger portion of our paychecks, Virginia’s health care system needs to become more transparent to allow for better decision-making. Having more and better cost information is key to improving routine health care decisions for consumers, employers, insurers, hospitals, public health officials, and policy-makers. To this end, we introduced bills creating an All-Payer Claims Database (APCD) that allows Virginia Health Information to collect medical claims from insurers, third-party payers, Medicaid, Tricare and Medicare (Senate Bill 135 and House Bill 343).
Twelve states currently have an APCD. Virginia’s Joint Commission on Health Care, on which we both serve, unanimously recommended establishing the Virginia All-Payer Claims Database. The APCD will allow for analysis and understanding of medical care that is not currently possible, particularly related to how and where Virginia’s health care dollars are spent. Understanding health care expenditure patterns and measuring quality and access are vital to improving access to health care, reducing costs, and enhancing quality of care.
An APCD can lead to better information about where to go for quality care; for instance knowing the frequency that a provider performs a medical procedure is often an important predictor of the provider’s ability to perform that procedure well. An APCD can facilitate better-informed public health decisions; identifying which regions of the state or age groups have the highest rates of diseases. This can allow scarce public health resources to be used for the most pressing problems. Employers may use APCD information to design benefit plans that encourage employees to use health care providers who deliver high quality at lower costs or to target their wellness programs to encourage the preventive care their employees are not receiving. Patient confidentiality will be protected.
Virginia was ranked by CNBC as the 2011 “Top state for Business.” Improving health care quality and value is essential to staying competitive in the long-term. To this end, the legislation passed overwhelmingly in a bipartisan fashion and had public support from hospitals, physicians, as well as the large and small business communities.
As we continue our move to an information-based economy, it is only fitting that data-driven health care information be available to allow for better informed decision-making.
Editor's Note: Senator Puller serves as Vice Chair of the Joint Commission on Health Care. Delegate O’Bannon also serves on the Commission, as well as Vice Chair of the House Committee on Health, Welfare, and Institutions, and Chair of Subcommittee #1.