Blue Cross Companies Contributing Comprehensive Health-Care Data

Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.

By Sara Hansard

Sept. 24 — For the first time, all 36 Blue Cross and Blue Shield companies will contribute comprehensive data on health-care quality and costs, the Blue Cross and Blue Shield Association (BCBSA) announced Sept. 24.

BCBS companies will collect data on more than 2.3 billion procedures conducted annually from more than 20,000 health-care facilities and 540,000 physicians to contribute to Blue Cross Blue Shield Axis, “an industry-leading data capability that is unprecedented in scope and scale,” the BCBSA said. “The commitment vastly expands the volume of data included in BCBS Axis, which reflects more than $350 billion in annual claims along with 36 million provider records and more than 700,000 BCBS patient reviews,” it said.

BCBS Axis provides employers, consumers and physicians “with accurate and actionable information,” the BCBSA said. BCBS companies cover more than 105 million members, one in three Americans, and their networks include more than 92 percent of physicians and 96 percent of hospitals nationwide.

Quadrupling Data Collected

Maureen Sullivan, senior vice president and chief strategy officer for BCBSA, told Bloomberg BNA Sept. 24 that the BCBSA board decided in November 2014 “to move forward now with quadrupling the amount of data we have on procedures.” The announcement reflects the fact that “now it is at a point where it's real,” she said.

The data collection required a “multimillion-dollar investment” from BCBS plans, Sullivan said. In the past BCBS companies contributed charge codes covering about 400 medical treatments and procedures to a central database, which has been increased to cover more than 1,600 medical claims, the company said in a release.

Sullivan said the data capability for Blues plans is “unparalleled” and is the likely the largest such data collection among private health insurers in the world.

Use of Database

BCBS members will be able to use the database to get information about the cost of a procedure no matter where they live, Sullivan said. Employers will be able to “look at patterns,” including comparisons of costs to care for patients with certain conditions across the country, and help determine interventions and support that are needed, she said.

Health-care providers meet with BCBS plans to review benchmarks and analyze why costs or services provided differ, Sullivan said. “Data is the enabler for those discussions.”

A report released in January by the BCBSA and Blue Health Intelligence, its data analysis unit, found that hip replacement procedures could vary in cost by as much as 313 percent in Boston, ranging from $17,910 to $73,987. Knee and hip replacement procedures are among the fastest growing medical treatments in the U.S., it said.

To contact the reporter on this story: Sara Hansard in Washington at

To contact the editor responsible for this story: Janey Cohen at

Request Health Care on Bloomberg Law