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UNM/NMSU study urges using New Mexico’s All‑Payer Claims Database to build a health expenditure database to identify cost drivers
Summary
A study by NMSU and UNM recommends building a health care expenditure database that uses the state All‑Payer Claims Database as a core and adds aggregated non‑claims data to better understand rising health costs and geographic disparities.
Researchers from New Mexico State University’s Arrowhead Center and collaborators at UNM presented a study proposing a health care expenditures database based on the state’s All‑Payer Claims Database (APCD) to give policymakers better, more timely insight into what is driving health spending in New Mexico.
Karen Monahan (Arrowhead Center) said the APCD’s public release covers a large portion of the market but typically excludes some payers; the presentation estimated the initial claims data might cover roughly 70%–75% of the market. Monahan recommended continued support for the APCD and using academic partnerships to capture and model non‑claims pieces (prescription spending, net private insurance costs, aggregated payments for excluded plans) so the state can generate actionable, more current expenditure estimates than federal datasets allow.
The presentation emphasized practical uses: disaggregating spending by condition, region and provider; identifying whether prescription costs, provider consolidation or labor are the main drivers; and supporting policy choices such as targeted price interventions or system‑level reforms. Committee members asked about gaps—particularly tribal, Indian Health Service and federal program exclusions—and presenters suggested data‑sharing agreements and aggregated reporting as possible ways to fill gaps.
Public commenters and health advocates urged the committee to use the database to identify systemic cost drivers, not only to publish price transparency. Mary Feldman of the Health Security Campaign cautioned that transparency alone is insufficient and that the database should inform systemic reforms; she also warned that approaches such as hospital global budgets raise complex political questions.
What happens next: presenters and committee members discussed follow‑up coordination with the Department of Health APCD team, possible research access for legislators and staff, and steps to improve coverage of tribal and federal program data through agreements and aggregated reporting.
