Case Studies

Resource	Category	Carriers	Purpose
A Preliminary Look at Chronic Conditions in Rhode Island If you are concerned about your family's health and the health of your community, then you have likely heard about chronic conditions like… State: Rhode Island	Consumers, Medicaid, Population Health	Commercial, Medicaid, Medicare	Cost, Utilization
Vermont’s Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact… State: Vermont	Consumers, Medicaid, Population Health, Providers	Commercial, Medicaid, Medicare	Cost, Quality, Utilization
Massachusetts My Healthcare Options Massachusetts led the nation in 2006 with a comprehensive health care reform law and the establishment of a new Marketplace: the Massachusetts Health… State: Massachusetts	Consumers, Health Reform, Insurance Department, Population Health	Commercial, Medicare	Utilization
Health Care Cost and Utilization Report This is the first report by the Health Care Cost Institute (HCCI) in cooperation with the Green Mountain Care Board (GMCB) about the health care… State: Vermont	Consumers, Medicaid, Population Health, Providers	Commercial	Cost, Utilization
Core Metrics Dashboard for Risk Adjusted Measures The Maine State Innovation Model (SIM) Core Measures dashboard shows trends on core healthcare measures selected by a statewide group of healthcare… State: Maine	Consumers, Health Reform, Insurance Department, Population Health, Researchers	Commercial, Medicare	Utilization
CIVHC Utilization Spot Analysis: Free Standing Emergency Departments This report finds that Coloradans using new free standing emergency departments (FSEDs) for non-life threatening conditions are paying more than if… State: Colorado	Consumers, Health Reform, Providers, Researchers	Commercial	Cost, Utilization
Leading Indicators for Oregon's Health Care Transformation The Oregon Health Authority published this report on using data from their state All-Payer All-Claims Database. The report examines the outcomes of… State: Oregon	Consumers, Employers, Health Reform, Insurance Department, Medicaid, Population Health, Providers, Researchers	Commercial, Medicaid, Medicare	Cost, Utilization
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

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