Leveraging the transparency of healthcare prices and costs can help consumers make better informed decisions about their healthcare, and policy makers can make this happen by creating an All-Payer Claims Database (APCD). APCDs are state run databases where consumers can compare healthcare related rates. Additionally, APCDs can help stakeholders, policy makers, and businesses make data driven decisions based on healthcare claims.
Currently, Michigan is one of 5 states that has an existing “voluntary” APCD, while 25 other states have legislation establishing an APCD. Of the 25 states who have APCDs, 9 of those states have consumer-facing websites utilizing their states APCD data.
Realistically, Michigan has a private “pay to play” APCD, which is called The Michigan Data Collaborative, which was created in 2010 by the University of Michigan. The Michigan Data Collaborative is funded by payers participating in their projects, which includes “Medicare, Medicaid, and the three largest commercial payers in the state: Blue Cross and Blue Shield Michigan, Blue Care Network, and Priority Health. The total membership from these five payers represents 80% of the market in Michigan,” which is roughly 40% of Michigan’s population.
In 2015, Michigan tried to enact legislation to create a state APCD and committee to oversee the uses and management of the data. However, the legislation died in committee. More recently, Michigan has had some positive legislation in trying to increase transparency for its citizens.
On May 18, 2021, Sen. Dan Lauwers (R) – Brockway Township introduced Senate Bill 447, which amends the Disability Insurance Policies of the Insurance Code. SB 447 fosters more competitive health care pricing by increasing transparency surrounding costs and coverage. At the request of a large employer group, an employer that enrolls over 100 employees, insurers must provide specific information about the costs and claims of its insurance plan. On June 30, 2022, Gov. Whitmer signed SB 447.
“Everyone knows insurance is a major cost in our lives. I’m glad the legislature and the Governor were able to support this change which can lead to greater transparency and lower insurance costs for the people of Michigan,” said Sen. Dan Lauwers (R) – Brockway Township
Policy makers can help their constituents make better informed data driven decisions about the cost of their health care by making sure healthcare services and costs are transparent.