Strategic Design for an All-Payor, All-Claims Database to Support Comparative Effectiveness Research

Added: Jan 21, 2010 5:51 pm The American Recovery and Reinvestment Act (ARRA) created a Federal Coordinating Council (FCC) for Comparative Effectiveness Research (CER) and charged it with developing recommendations on how t invest funding appropriated to the Secretary for comaprative effectiveness research. The Council recommended, and the Secretary agreed, that a robust longitudinal claims infrastructure to support CER was critical.



There exist a number of databases with longitudinal claims data that could facilitate analysis of such data for CER purposes. Each, however, has limitations in its application to CER. The Centers for Medicare and Medicaid Services (CMS) Integrated Data Repository (IDR), Chronic Conditions Warehouse (CCW), and Medicaid cliaims files (MAX) databases include data only on the Medicare and Medicaid populations; state-based all-payor, all-claims databases are limited geographically in scope and by variability in infrastructure design and state capabiliity; private databases may include information on a more demographically diverse population, but are still fragmented and often accessible to researchers due to cost.



An all-payor, all-claims database would allow for greater power in analysis, ensuring taht the data infrastructure the Secretary supports will be able to produce robust analysis. If developed well, this database would be a representative sample of the population and could be built upon over time. The public commentary at FCC listening sessions affirmed the value of an all-payor, all-claims database. Claims data, especially if established in a manner where it can be linked to other data over time, can be a powerful tool for CEr and ultimately improve care for all Americans.



Given the breadth of potential options for building an all-payor, all-claims database and the significant investment required to do so successfully, the awarded contract is for a targeted design study to inform the creation of such a database and supporting services, methods, and skills. Additionally, the awardee may be involved in supporting tranistion to an implementation of such a database under the contract.



The period of performance is for 12 months.