This longitudinal data source contains over 2 billion claims, which is regularly updated. Using this data source, health plans and providers can more easily create a value-based payment (VBP) strategy by providing insight into regional episode volumes, provider performance, care team options, competitive benchmarks, and more.

Features:

  • De-identified Membership and Demographics—containing information such as age, gender, and location of residence
  • Provider Identification—providers within the information remain identified, which can be linked to other data sources via the providers’ NPI key or probabilistic demographic matching
  • Monthly Health Plan Enrollment Information—conveys characteristics of the plan and plan type in which the consumer is enrolled
  • Medical Claims Information—contains a set of the paid and denied claims for all types of medical coverage (e.g. institutional, physician, and ancillary care provider claims)
  • Prescription Drug Claims Information—for consumers with prescription benefit coverage, the information contains a set of filled script claims
  • Lab Information—contains numeric laboratory data from automated lab systems

HealthQx National Data Source Helps Health Plans:

  • Improve analysis processes and results through access to a robust longitudinal data source.
  • Quickly understand national and regional healthcare trends.
  • Improve ability to understand provider network composition and identify potential service gaps.
  • Provide a data enrichment source for incomplete data sources.