COMPREHENSIVE HEALTH DATA SYSTEMS SPANNING THE PUBLIC-PRIVATE DIVIDE - THE MASSACHUSETTS EXPERIENCE

As system of health care delivery have evolved from claims-based fee-f or-service to capitated or managed care, with its emphasis on cost-eff ectiveness, quality, and performance measurement, some states have beg un to experiment with new ways to collect, organize, and share health information. In many cases, the drivers of these changes have been pur chases of health care, including large and small private employers nad public agencies such as Medicaid. One of the results of these changes is the increased interest in the sharing of health information, betwe en health plans and employers, and in some instances, between private plans and public agencies such as public health. Massachusetts, which has one of the highest rates of managed care collection and utilizatio n of health information, to craft agreements on standards and protocol s that will allow the sharing of health data. While much of the activi ty involves business transactions between private sector health plans, the Department of Medical Assistance (Medicaid) has joined with its p rivate sector purchasing partners in demanding cost-effective, high-qu ality care; it is these demands that have helped stimulate the need to reorganise previously proprietary health information systems. The act ivities of two public-private coalitions, the Massachusetts Healthcare Purchaser Group and the Massachusetts Health Data Consortium, have be en critical in initiating and supporting the complex processes that ha ve led to significant changes in state-based systems of health informa tion. (C) 1998 American Journal of Preventive Medicine.