California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Covered Calif. Seeks Consumer Data, Triggers Privacy Concerns

Health care stakeholders are concerned about Covered California's plans to collect and use private consumer data to address health care disparities in the state, the Sacramento Bee reports.


In contracts with health insurers, the state health insurance exchange requires health plans to work with Covered California "to determine how data can best be collected and used to support improving health equity."

The exchange seeks to reduce health disparities across:

  • Disability status;
  • Ethnicity;
  • Gender;
  • Gender identity;
  • Primary language;
  • Race; and
  • Sexual orientation.

Covered California Executive Director Peter Lee earlier this year said that the exchange seeks to be "a results-driven organization, including looking at how we are promoting better health and health equity while lowering costs for all Californians."

Privacy Concerns

Although Covered California said its insurer contracts do not violate HIPAA privacy rules and regulations, some experts think efforts to collect private data could be problematic for the exchange.

Sally Pipes, president of the Pacific Research Institute, said collecting such data puts exchange officials on a path to "a place that they definitely should not be going." She said the task of collecting such information should be handled by research institutions.

Pipes added that "[t]he more information people have to give out, the more room there is for fraudulent activity."

In addition, Emily Rusch -- state director for the California Public Interest Research Group -- said, "We support the sharing of this information if and only if this information is aggregated and de-identified when the insurers provide it to the exchange, so that individual consumer information is kept confidential."

Stephen Shivinsky -- spokesperson for Blue Shield of California -- said the insurer would not release enrollee-specific confidential data unless the exchange is able to demonstrate that it is lawful to do so.

Meanwhile, Christian Stenrud -- spokesperson for Kaiser Permanente -- said the insurer has not yet had detailed conversations with the exchange about providing personal data. However, any data that the insurer provides to Covered California will be de-identified and comply with all federal and state laws, according to Stenrud.

In addition, some insurers say they are willing to work to boost health equity in the state, but they want to receive financial incentives for doing so.

Stenrud said, "Data collection is only the first step," adding, "If we want to eliminate health disparities, health care payers like Covered California should reward health plans and delivery systems when they can show superior, or greatly improved, performance for populations that have historically shown poor health outcomes" (Cadelago, Sacramento Bee, 12/2).

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