NEW ORLEANS, LA – Findings from a data warehouse containing medical claims from three of Louisiana’s major payers reveals unwarranted variations in care throughout the state.
In addition, the data indicates that high payer costs do not ensure better quality, and a lack of access to primary care is forcing the uninsured to use emergency rooms.
The baseline data gathered from Blue Cross and Blue Shield of Louisiana, Medicare and Medicaid will help policymakers and other stakeholders shape the state’s healthcare reform, said Karen DeSalvo, assistant to the president for health policy at Tulane University and a board member of the Louisiana Health Care Quality Forum (LHCQF).
Health Dialog Services presented the report, developed by its subsidiary Health Dialog Analytic Solutions, to the LHCQF Summit at Tulane University.
David Wennberg, president and COO of Heath Dialog Analytic Solutions, said the diverse audience of public and private stakeholders understands the issues at hand and is motivated to make change.
“One of the problems for us is we haven’t had a clear picture whether quality or cost problems are pervasive,” said DeSalvo. “We have a better picture from the multi-payers.”
The findings will help frame the way LHCQF and the state pick measures to address and solutions to implement, particularly around access to care, the reduction of cost without sacrificing quality and the reduction of unnecessary procedures.
The multipayer database has been central to several Centers for Medicare and Medicaid Services initiatives and demonstration projects, said Wennberg. “It has taken us so long to realize how powerful data is,” he said.
DeSalvo credited the payers for their willingness to share information. “There’s a lot of openness,” she said, of the payers, as compared to the physician community, which is not yet ready to show group level data.
The uninsured population in the state is measured at 20 percent, or one out of every five residents. DeSalvo said expanding coverage to the uninsured would allow the data warehouse to track them.
Despite the uphill battle created by Hurricane Katrina, Louisiana’s healthcare system, which essentially hasn’t changed for decades, has been pushed to the nation’s forefront. For once, DeSalvo said, the state has the opportunity to lead the nation in healthcare reform.