American states large and small are creating all-payer claims databases as a way to make transparency and shopping a reality for insurance consumers.

Rhode Island and California, for instance, are already embarking down that path. 

Six years after the Rhode Island legislature authorized the state health department to create an all payer claims database, in fact, the agency is using new funding to bring that to the public. Home to a little more than 1 million people, Rhode Island is on schedule to launch its all payer claims database this year.

Contracting with Arcadia Healthcare Solutions, OnPoint Health Data and 3M Health Information Systems, the Rhode Island Department of Health is aggregating and presenting data on medical claims, pharmacy claims, healthcare providers and member enrollment from commercial and public payers — in an effort to give the general public new sources of information to compare hospitals, doctors and pharmacies.

The data will be de-identified and aimed at ensuring “transparency of information about access, quality, utilization, efficiency, and cost of Rhode Island’s healthcare delivery system,” the state health department said.

The data submission — with historical data going back to 2010 — may be another piece of administrative work for Rhode Island insurers and insurers in other states with APCDs, but it should be fully digital and thus minimally invasive.

Perhaps a bigger issue they do have to overcome is explaining the new use of data to members — emphasizing that it is de-identified, while also giving them the choice to opt out.

“The database provides reports about healthcare quality, cost and reforms," Aetna told members in its communiqué. "Policy makers will use it to help them make better decisions regarding healthcare quality.”

Rhode Island will join more than a dozen other states with an established voluntary or state-mandated all payer claims database and more are in the planning and design stages. The long-term benefits of the databases remain to be seen, depending on how they are presented and how many consumers use it for decision-making.

Across the country, one of the largest states is also giving it a try. In California, the nation’s largest state by population and one where insurers are trying to both improve member value and collaborate with providers, a voluntary all payer claims database in getting underway.

Using federal funds allocated by Department of Insurance, the University of California at San Francisco is creating an online database to show average prices across geographic areas for common health services.

"Consumers today have limited or no access to information about the price and quality of healthcare services before they receive care,” said California’s insurance commissioner Dave Jones. “Purchasing healthcare is like shopping in a department store with a bag over your head — you have no idea what the medical costs are before you get the bill. Transparency in medical pricing should improve competition and result in lower medical costs, as patients will vote with their feet if medical provider prices exceed those of competitors."