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How All-Payer Claims Databases (APCDs) Can be Used to Examine Changes in Professional Spending: Experience from the Rhode Island APCD. | LitMetric

AI Article Synopsis

  • States are focusing on health care spending reform as federal efforts stall, with Rhode Island’s All-Payer Claims Database used for analysis from 2016 to 2019.
  • Medicaid professional spending grew significantly faster than commercial spending, at 5.2% annually compared to 2.7%.
  • Key areas of spending increase included services like nurse practitioner and physician assistant evaluations, behavioral health, and orthopedic procedures, with variations in how price and volume contributed to these trends over the three-year study.

Article Abstract

States are increasingly the focus of health care spending reform efforts given political deadlock at the federal level. Using the Rhode Island All-Payer Claims Database (APCD) from 2016 to 2019, a modified National Uniform Claim Committee (NUCC) provider taxonomy, and the 2021 Restructured BETOS Classification System (RBCS), we evaluate professional spending trends in commercial and Medicaid populations, identify specialties and clinical service categories driving trends, and examine price and volume contributions to spending changes. We found that professional spending from 2016-2019 in Medicaid is increasing faster than professional spending in commercial (5.2% vs. 2.7% annually). We also found that nurse practitioner and physician assistant evaluation and management (E&M), behavioral health services E&M, anesthesia, diagnostic radiology imaging, and orthopedic procedures were among the largest areas of spending increase during the study period in Rhode Island. Three-year trends showed heterogeneity in whether volume or price was primarily responsible for these spending increases.

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