In the majority of states that have implemented APCDs, data submission is mandatory, and statutory penalties (some very costly) are enforced for delayed entries. Some states make APCD data available to the public for free in a consumer-ready form. Some states sell the data to businesses that are eager to digest it for their own uses, and still other states only allow restricted access to the system.
In places where access is not restricted, consumers can make informed decisions about their health care spending and even elect where to receive their services at a lower cost. Businesses can evaluate coverage costs and services that are provided to employees and use such information to provide more cost-efficient insurance to their workforce.
Policymakers are generally key stakeholders in the creation of APCDs. Most of these systems are run by the government, though it is possible to have a non-governmental, external agency in control (as Colorado does). Typically, APCDs are the by-product of legislation. It is important for any legislative efforts to outline several essential components:
- Who will be in charge of the management and oversight of the system?
- What are the technical and logistical needs of the system?
- What formats and policies will be used? What penalties will govern?
- What will be the funding source?
Once an APCD is established, policymakers reap the rewards. The data is invaluable for legislators and officials; they can evaluate specific health care in their area, decide what programs need to be implemented and/or eliminated, and what cost-savings measures can be instituted at the governmental and private level.
With consumers and policymakers both benefiting from the creation of state APCDs, it looks like the systems are a win-win.
McBrayer, McGinnis, Leslie & Kirkland, PLLC