Linking Cancer Registry Data to Claims Data from BCBSM

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Linking Cancer Registry Data to Claims Data from
BCBSM

• MCC Board of Directors
• Sept. 21, 2005
• Okemos

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Why is it important to BCBSM?

• Potential to improve quality of cancer care
• Potential to develop/improve care management
  programs
• Supports BCBSM Social Mission promoting the
  art and science of health care

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Project History
2001
2002
2004
2005
2003
Policies procedures for research training
Request T. Simmer, MD
Work begins
Work begins again!
Prelim results
Address privacy contracting
HIPAA
Contract w/ MDCH
IRB
sign
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Blue Cross Blue Shield of Michigan

• Non-profit health insurance company
• 54 commercial market share within Michigan. The
  next largest competitor has a 6 share

Health Care Enrollment by Product
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Insurance Products
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BCBSM Membership Summary

• Top 10 customers
• General Motors
• Ford Motor Company
• Michigan Public School Retirees
• MESSA
• State of Michigan
• DaimlerChrysler
• Detroit Regional Chamber
• Federal Employee Program (FEP)
• Small Business Association of Michigan

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Membership by Age
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Pilot Project Overview
MI Cancer Surveillance Registry
BCBSM Claims Admin Files
Demographics Outcomes Clinical Information Treatme
nt Information Economics
MI Mortality File
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Pilot Link to BCBSM Process

• Membership file to DCH 1998-2002
• Link to Registry
• Identify Cases
• Develop Study Cohort
• Select matched cancer freecontrols
• Return Study Cohort to BCBSM
• Pull Claims
• DCH Receives Claims Data
• Develop Linked De-Identified Study Files
• Forward Study File to BCBSM for Analysis

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Key Steps

• Pilot Proposal
• Contract with BCBSM/DCH
• DCH IRB Approval
• DCH Designated as IRB for BCBSM
• Partial CDC Funding for BCBSM

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Status

• All Agreements in Place
• Preliminary Link to BCBSM
• Data Set Defined
• BCBSM Developed Membership File
• DCH Developing Linkage Strategy
• Developing Approach to Quality Analysis

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Preliminary Link

• Enrollment File for 1998-1999
• 4.8 Million Participants
• Linked to Registry
• Probabilistic Match
• Identified 32,000 Cases
• Above expectation

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Potential BCBSM Plans for Data Support Treatment
and Payment Functions (1)

• Analyze incidence/burden of cancer with respect
  to demographic and social characteristics
• Provide and compare with benchmarks
• Validate uses of administrative data for cancer
  programs using gold standard

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Potential BCBSM Plans for Data Support Treatment
and Payment Functions (2)

• Support disease management programs
• Cost of treatment and use of services
• Cost per outcome (utility analyses)
• Cost of survival
• Insurance coverage issues
• Delivery system geographic variation,
  providers, etc.

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Potential BCBSM Plans for Data Support Treatment
and Payment Functions (3)

• Improve quality of care
• Use of evidence-based guidelines
• Impact of EBG on costs and outcomes
• Time between dx and treatment
• Patient and provider factors in treatment
  decisions

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Potential BCBSM Plans for Data Support Treatment
and Payment Functions (4)

• Improve quality of care
• Racial/ethnic/gender disparities
• Small area variation studies
• Quality management studies
• Feedback information to providers Centers of
  Excellence, provider incentive programs

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Potential BCBSM Plans for Data Support Treatment
and Payment Functions (5)

• Correlations of cancer with other
  conditions/diseases inflammatory disease, GERD,
  Obesity, Depression
• Survivorship

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Potential BCBSM Plans for Data Support for
Public Policy and Social Mission

• Help public health agencies evaluate the quality
  of treatment data in cancer registries
• Research to inform decisions about allocating
  health care resources, in MI and BCBSM
• Literature contributions commercial groups
• Eventually an all payer database in MI

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Next Steps

• Complete Phase 1
• Linkage
• Validity tests
• Demonstration of value
• Obtain support from MCC Board
• Plans for Phase 2 (next year)