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Claims and Provider Payment Data Gaps for Responding to COVID-19

Publication Date
Richard Dunville, MPH; Emily Grenen, MSc; Megan Cotter, MPH; Meaghan Hunt, BA; Sarah Koltun, MPH; Kai MacLean, BS; Jaleh Montazer, MPH; Elizabeth Ramirez, BS; Valentina Caro, BA; Violanda Grigorescu, MD, MSPH; Steven Sheingold, PhD; Rachael Zuckerman, PhD

This report and accompanying discussion by ASPE and NORC highlights the claims data limitations identified during the COVID-19 Public Health Emergency Health (PHE) and provides considerations to address these limitations. The report identifies that limitations related to claims data were existing issues, exacerbated by, but not unique to, the COVID-19 PHE. The study also found limited transparency about claims data management and availability, as well as limited research utility of claims data alone for the COVID-19 PHE.

Improving the utility of claims data may be achieved through better data collection and availability; standardization of claims data across payors and database providers; and active engagement of the health care ecosystem, private sector included. Although the gaps identified are not specific to the COVID-19 PHE, the urgency in implementing solutions is driven by the potential risk of additional PHEs in an unforeseen future and should be addressed proactively, before another PHE.

*This content is in the process of Section 508 review. If you need immediate assistance accessing this content, please submit a request to Rachael Zuckerman, (202) 969-3817, Content will be updated pending the outcome of the Section 508 review.