The New Mexico Department of Health (DOH) has had the goal of establishing a new health insurance claims database for a while now.
The DOH announced Wednesday that a database is on the way.
The database will go live in early 2023. All Payer Claims Database (APCD) will include cost, quality and other data that’s never before been available to the public.
DOH selected Milliman MedInsight, a nationally recognized health data and analytics company, to work with the state to collect paid medical and pharmacy claims information from private insurance companies as well as Medicare and Medicaid.
“Creating this database will allow New Mexicans to make better informed decisions about their health care and help patients and their families choose where to receive care based on cost and quality,” said Acting Department of Health Secretary David R. Scrase, M.D.
More than 20 other states have established similar databases over the past two decades, including Colorado, California and Arizona. For some other states, the databases exposed issues in the healthcare system.
A 2019 study , which used Virginia APCD data, revealed potential under-treatment of pain related to cancer.
Washington found through use of its APCD data $282 million was unnecessarily spent on low-value care. (Examples of low-value care include inappropriately prescribing antibiotics, running lab tests for low-risk patients before low-risk medical procedures or performing surgeries when physical therapy would be equally effective.)
The use of the new database will help care seekers see if their money is being properly used and if they are getting the best care in New Mexico. Many people are tired of being short-changed on their healthcare.
“Having this database will enable better informed health policy,” said Russell Toal, New Mexico Superintendent of Insurance.