OPM to Launch Federal Employees Claims Database

Jeff Elliott for HealthLeaders Media, October 11, 2010

Healthcare reform has come to the Office of Personnel Management (OPM), the agency charged with managing the federal government's civil service personnel. In accordance with a mandate in Affordable Care Act passed earlier this year, OPM has created the Health Claims Data Warehouse, a database of personal information generated from employees' healthcare claims.

Records from the current Federal Employee Health Benefit Program (FEHBP) and National Pre-Existing Condition Insurance Program populate the database, which OPM says will help the agency track the costs of care delivered to enrollees. Data from a third program, the Multi-State Option Plan, will be added when it gets underway in 2014.

According to a statement from OPM Director John Berry, the Health Claims Data Warehouse is intended as a tool for analyzing health services data from [federal employee health benefit plans.] "The warehouse will allow OPM to better understand the health of federal employees, as well as the cost and quality of care they receive. The warehouse will give OPM the ability to manage the program so that employees and tax-payers get the best value."

Recorded data—kept for a seven-year period—will include personal identifying information such a patient's name, Social Security number, date of birth and gender; contact information including phone number and address; provider charges and reimbursement amounts; and specific medical details including diagnoses and procedures.

OPM says it will use the information to provide economic modeling of health trends, risk-adjusted profiles, pharmacy pricing, and provider contracts. However, the law allows for other "routine uses" such as by law enforcement agencies that are "investigating, prosecuting, enforcing or implementing a statute, rule or order" as well as when the data is needed in response to congressional inquiries or for judicial proceedings.

Margaret Dick Tocknell Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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