At UT Health’s School of Public Health in Houston, the Center for Healthcare Data works to increase health data transparency across the board
By Ivy Ashe
Population Health Scholar
University of Texas System
PhD Student in Journalism
UT Austin Moody College of Communication
Health care costs are often a mystery. What is the breakdown of a treatment process? Why is one procedure more costly than another? How do insurance providers calculate charges? At UTHealth’s School of Public Health in Houston, the Center for Healthcare Data works to answer these questions by increasing transparency across the board.
The center was funded by a $1.5 million grant from Blue Cross Blue Shield of Texas, which also provided its claims data to kickstart the database. From there, the center has grown to include data from other private, state and national sources. It is now a massive trove of data, with files and records from sources including most commercial payers and public payers, as well as the Texas Department of Insurance, Texas Medicaid, UT Physicians (the largest physician provider group in Texas), CERNER Health Facts, and the Texas Worker's Compensation Commission.
In total, the Center has data that covers millions of Texans, by one estimate more than 65% of the state’s population.
It is also one of a handful of organizations nationwide that is a Centers for Medicare and Medicaid Services (CMS) Qualified Entity (QE), meaning that it receives Medicaid and Medicare claims data to help produce public reports on insurance provider performance.
“Getting that QE certification really defined one of our key objectives, which is working towards transparency,” said Dr. Trudy M. Krause, Center for Healthcare Data co-director.
“It’s really grown in recent years. People across the state have learned what we do, and we’re pleased that people now approach us. They’ve recognized us as a valuable source of data that is representative of the population.”
The information in the Center for Healthcare Data is used not only by researchers at University of Texas institutions, but by its students, particularly for dissertation work, and by researchers outside of the UT system. Co-director Dr. Cecilia Ganduglia Cazaban estimated that about 24 active projects are currently using the servers.
“They all focus around those types of issues relating to costs or quality measurements, improving quality of healthcare, and informing policy,” she said.
One specific contract with the state, for example, examined Medicaid claims data for newborns born between 2009 and 2014, linking that information with the infants’ birth and death certificates. That allowed researchers to help determine total cost of care for Texas’ neonatal population.
Having the data all in one central location allows researchers to hone in on variability among different populations in the state.
“There is immense variation among providers and payers, and across different regional geographic areas in the state,” Krause said. “There are good reasons for some of that variation, but not all of it. Allowing researchers to access the data allows us to understand the reasons for the variation, and ideally to identify mean prices for different procedures, practices, prescriptions, and so on.The ultimate goal is for patients to have consistency across the board, to know the average prices, and to trust that quality of care is the main thing driving the cost.”
No researcher gains access to the entire data bank at the center. Instead, people are given access to the servers, and analyses are run directly on the Center’s secure servers. There are multiple layers of security to protect the privacy of the patients whose records are being studied. The data is stored on encrypted servers. Every project has to receive Institutional Review Board (approval), and the data that investigators receive is stripped of all personal information except what’s necessary to their project.
“We’ll give only the data you need to answer your research questions,” Ganduglia Cazaban said.
Krause emphasized that the Center, which is housed in the department of management, policy and community health at UTHealth School of Public Health, is a place for collaboration.
“It’s a research, public policy, and professional opportunity,” she said. “We never overlook the fact that we’re trying to train professionals in the field. We want all UT institutions to feel like they can access this data, that it’s available to them.”