Evidence reviews are powerful tools that allow health policymakers to direct resources to certain options that outperform others. Evidence-informed approaches can optimize coverage decisions, increase performance on quality improvement measures, and drive effective responses to major challenges. One way states are utilizing these evidence-informed approaches is in addressing the opioid crisis.

Data for Change: How States Have Used APCDs to Drive Innovation

State-run all-payer claims databases (APCDs) are a critical public resource and serve a unique function in the current era of health care reform. APCDs, which are operating in 18 states, provide fair and equal access to independently validated data that can both support evidence-based policymaking as well as help patients navigate the health care system. These databases are also the only publicly accessible, independent resources available to analyze the billions of dollars spent on health care through private health insurance markets.

APCDs saw a setback earlier this year in Gobeille v. Liberty Mutual ,when the Supreme Court held that ERISA prohibits state mandated reporting by self-insured plans. Without claims data from self-funded sources, APCDs will be unable to provide a comprehensive picture of health care spending and use,[1] and as a result these databases will be considerably less valuable to the leaders and consumers that have come to rely on them.

Before Gobeille, states were making important strides in collecting and validating claims data from payers and beginning to leverage this information to drive health care reform efforts. Below are just a few examples of the ways states have been able to use APCD data to improve care and lower costs.