Case Studies

Resource	Category	Carriers	Purpose
2008-2009 Professional Services Utilization: Trends Among Privately Insured Patients This report examines the use of professional health services by privately insured Maryland residents in 2009 and the payments made to practitioners… State: Maryland	Health Reform, Insurance Department, Providers	Commercial	Cost
Spending and Use Among Maryland's Privately Fully Insured This study examines changes in healthcare expenditure and utilization in the individual and small group markets following the implementation of new… State: Maryland	Employers, Health Reform, Insurance Department	Commercial	Cost, Utilization
The Evolving Landscape of Health Care Reform and Health Care Spending in Maryland This study focuses on Maryland's health care spending following their initiative to meet the 'triple aims' of health care reform:… State: Maryland	Health Reform, Providers, Researchers	Commercial	Cost
Payment for Professional Services In Maryland: Factors Contributing to Variation and Comparison to Public Payers This study examines variation in payment rate among commercial carriers in Maryland and compares this with Medicare and Medicaid payment rates. The… State: Maryland	Health Reform, Insurance Department, Providers	Commercial, Medicaid, Medicare	Cost
Payment for Professional Services in Maryland Private payment rates for professional services in Maryland are compared with Medicare and Medicaid payment rates for the same services. Data and… State: Maryland	Health Reform, Medicaid, Providers	Commercial, Medicaid, Medicare	Cost
Impact of the Assignment of Benefits Legislation The Maryland Health Care Commission's report assesses the impact of the Assignment of Benefits and Reimbursement of Nonpreferred Providers law… State: Maryland	Consumers, Health Reform, Insurance Department, Providers	Commercial	Cost
Assessment of Changes in Advanced Imaging Referrals by Orthopedists 2010-2012 This study examines the trends in prescribing magnetic resonance imaging (MRI) services in Maryland following the divestiture of ownership of MRI… State: Maryland	Health Reform, Insurance Department, Providers	Commercial, Medicaid, Medicare	Utilization
Utah Health Status Update: Using Clinical Risk Groups to Analyze the Utah All Payer Claims Data Utah All Payer Claims Database (APCD) uses the 3M Clinical Risk Group (CRG) software to show clinically-meaningful categories using diagnoses,… State: Utah	Insurance Department, Medicaid, Population Health, Researchers	Commercial, Medicaid	Cost, Utilization
Small Geographic Area Variations in Prescription Drug Use This study seeks to quantify variation in pediatric pharmacotherapy across small geographic regions and payer type (commercial or Medicaid). All-… State: Maine	Consumers, Medicaid, Providers, Researchers	Commercial, Medicaid	Utilization
NH HealthCost Website The HealthCost website (http://www.nhhealthcost.org/) provides information for consumers and employers about the price of medical care in New… State: New Hampshire	Consumers, Employers, Insurance Department, Providers, Researchers	Commercial	Cost, Quality, Utilization
Green Mountain Care Board Data Analytic Plan Health care accounts for nearly one-fifth of the state economy. Spending is growing faster than any measure of our ability to pay. At the same time,… State: Vermont	Consumers, Health Reform, Population Health, Providers	Commercial	Quality, Utilization
Green Mountain Care Board Price Variation Analysis The GMCB referenced a January 2012 report commissioned by the Department of Vermont Health Access that found “there was significant variation in the… State: Vermont	Consumers, Employers, Providers	Commercial	Cost, Utilization
Prescription Use among Children with Autism Spectrum Disorders in Northern New England: Intensity and Small Area Variation This report measures the intensity of prescription use and regional variation of psychotropic and two non-psychotropic drugs among children with… State: Maine	Consumers, Population Health, Providers, Researchers	Commercial, Medicaid	Utilization
Exploring Shifts in Insurance Products after ACA This study explores the shift in popularity of different commercial insurance products following the adoption of the ACA. Significant focus is given… State: New Hampshire	Consumers, Employers, Insurance Department	Commercial	Utilization
Enrollment Trends: July 2016 Edition Enrollment Trends monitors health insurance coverage in Massachusetts. Coverage is defined as primary, medical insurance administered by the top 14… State: Massachusetts	Consumers, Employers, Health Reform, Insurance Department, Medicaid, Researchers	Commercial, Medicaid, Medicare	Utilization
Performance of the Massachusetts Health Care System: Annual Report September 2016 The Center for Health Information and Analysis' (CHIA) annual report on the Massachusetts healthcare system monitors quality and cost trends… State: Massachusetts	Consumers, Employers, Health Reform, Insurance Department, Medicaid, Providers, Researchers	Commercial, Medicaid, Medicare	Cost, Quality, Utilization
MassHealth Baseline Statistics from the MA APCD This report provides baseline information about MassHealth's eligibility and claims data. MassHealth is the Commonwealth's combined… State: Massachusetts	Health Reform, Insurance Department, Medicaid, Providers, Researchers	Medicaid, Medicare	Cost, Utilization
Quick Cost and Plan Finder Connect for Health Colorado and the Center for Improving Value in Health Care (CIVHC) partnered to develop the Quick Cost and Plan Finder Tool that… State: Colorado	Consumers, Health Reform, Insurance Department	Commercial	Cost, Quality
Risk-Adjustment Methods for All-Payer Comparative Performance Reporting in Vermont This research study evaluates the effectiveness of different risk-adjustment models for comparing claims data for populations served by Medicare,… State: Vermont	Health Reform, Medicaid, Population Health, Researchers	Commercial, Medicaid, Medicare	Cost, Quality, Utilization
Healthcare Cost in Utah: Brief Summary of the 2014 Utah All Payer Claims Data The Utah Department of Health released this summary report on healthcare costs based on data from Utah's All Payer Claims Database (APCD). This… State: Utah	Consumers, Population Health, Researchers	Commercial	Cost, Utilization

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