Covered California To Collect, Mine Enrollees’ Health Care Data

Covered California plans to collect data on how exchange enrollees use their health coverage in an effort to measure care quality, hold insurers and providers accountable and potentially negotiate better premiums, the Los Angeles Times reports.

Details of Data Collecting Initiative

In April, Covered California entered a five-year, $9.3 million contract with Truven Health Analytics to collect insurer data on enrollees':

• Hospital stays;
• Physician visits; and
• Prescriptions.

For example, the exchange will examine how many diabetic enrollees are receiving care management for the condition, according to the Times. It also will look at the number of cancer screening tests that resulted in early diagnoses.

Under the initiative, Truven will strip identifying information from the data before sending the information to state researchers.

Data will not be collected until this fall, at the earliest, according to the Times. However, the data collected could include earlier claims information.

Privacy, Security Concerns

Some observers have raised concerns about how the initiative could affect the privacy and security of enrollees' data.

Covered California Executive Director Peter Lee acknowledged that exchange enrollees will not be given the option to opt out of the data collection initiative. He said, "To understand the quality of care being provided, you need everybody in."

However, Lee said the exchange will ask for feedback on the initiative from consumer groups and medical experts.

Michelle De Mooy, deputy director for consumer privacy at the Center for Democracy and Technology, said, "There is potential for so much public good [in the data collection initiative], but there is a greater public good in protecting privacy and security," adding, "I think asking permission is absolutely integral."

Glenn Cohen, a Harvard Law School professor and expert on the ethics of using health data, said, "The more voice you give to patients in this process, the more ethically justified you are doing this with big data."

Meanwhile, insurers and Covered California officials say that sharing data for analytic purposes is nothing new. "For the vast majority of Americans, this information is already shared on a daily basis with protections in place," Lee said (Terhune, Los Angeles Times, 6/21).