Managed Healthcare Executive - March 2009 - (Page 7) NEWS ANALYSIS Drive more data JULIE MILLER EDITOR IN CHIEF NATIONAL REPORTS — Managed care plans need to prepare for new and more complex reporting of their aggregated data, experts say, particularly as health reforms accelerate at the federal level. “President Obama’s proposal for healthcare reform is going to be big on the need for plans to do more with their data,” says Leon Cosler, professor, Albany College of Pharmacy and Health Sciences. He says an increased responsibility could be placed on plans to provide information to providers and other stakeholders on evidence of care disparities. “If the proposals are going to require additional reporting for dispari- ties—which for example might rely on reporting di erences in care by race or ethnic origin—then there are some pieces of information that will tend to be less complete for plans,” Cosler says. “Race is one example that in past hasn’t been a strong basis for reporting and hasn’t gotten a lot of attention.” Aetna and some large insurers have just begun to collect race and ethnic-origin data voluntarily from members for the sake of caring for speci c populations at risk for certain diseases or more severe morbidity related to chronic conditions. Cosler says plans hold huge information sources within their claims data, but the data isn’t particularly useful until it’s aggregated, sorted and synthesized into meaningful results, and that process can be extremely complex from a technology standpoint as well as from a regulatory standpoint. Robbi-Lynn Watnick, senior healthcare compliance consultant for the Altarum Institute, a non-pro t objective research and consulting rm, says HIPAA protections provide necessary security for the data, so additional steps required to achieve HIPAA compliance must be followed when plans translate their data. Some experts forecast that federal regulators could examine HIPAA and other existing rules in the context of new reporting requirements and determine that the rules need modi cation. It’s purely conjecture, but the idea is not entirely far-fetched, according to Cosler. Any potential modi cation of HIPAA would depend on “what line policy makers are willing to cross or willing to stand on,” Watnick says. MHE Has Medicare Demand proven a little too demanding? Partner with a company that considers your success its top priority. The Jacobson Group provides rapid response teams of health insurance specialists - claims, billing, customer service - to help clients manage critical workloads. This is just one of the ways we have been supporting our clients’ talent needs for nearly 40 years. (800) 466-1578 WWW.JACOBSONONLINE.COM MARCH 2009 7 http://www.jacobsononline.com http://www.jacobsononline.com
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