Using Data Exchange to Improve Quality Reporting, Target Outreach, and Reduce Cost

AJMC May 13, 2025
Barbara Rubino, MD, Chelsea Hart-Connor, MA, Todd A. May, MD

Covered California and Health Net’s novel data exchange initiative significantly improved quality measurement and potentially reduced costs by more than $640,000.

ABSTRACT

The burden of collecting data and reporting on quality measures is a strain on both providers and payers, exacerbated by the multitude of required metrics and disparate data systems. Covered California, the California health benefits exchange that supports more than 1.9 million Californians receiving insurance through the Affordable Care Act, and insurance carrier Health Net, serving approximately 138,000 members on the exchange, implemented a novel approach to data exchange using Covered California’s all-payer claims database (APCD). This initiative used historical cancer screening data for Health Net enrollees who had been insured under different Covered California plans in the...

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