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Smart Health-Care Strategy Hidden in ‘Cliff’ Deal

Author: Peter R. Orszag
January 8, 2013


One little-noted provision I was encouraged to see tucked in last week's fiscal-cliff legislation is Section 601(b): an incentive for doctors to expand their use of something called clinical data registries.

These registries collect information on patient characteristics, patterns of care and outcomes that can be crucial to evaluating what medical techniques and strategies work and which ones don't. Unfortunately, registries are not as widespread as they should be -- and the ones that exist often are limited to particular types of care.

Data from insurance-claim forms, in contrast, are easier to obtain and more comprehensive across episodes of care. However, these reveal only which tests and procedures were performed, and tell very little about how the patient fared.

What would be ideal for people who analyze health-care practices would be to have some way of combining registry and insurance-claim data. As the Engelberg Center for Health Care Reform at the Brookings Institution emphasized in a 2010 white paper, one could "describe registry data as 'an inch wide and a mile deep,' and claims data as 'a mile wide and an inch deep.' Linking these data sources can overcome the shortcomings of each to produce information that is both comprehensive and clinically detailed."

Such linking requires, first, a matching algorithm that can make sure Jane Smith in the insurance-claims database is the same Jane Smith found in the clinical-data registry. It also requires getting the clinical data into a registry in the first place.

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