Delaware Public Media

DHIN launches statewide health insurance claims database

May 3, 2019

The Delaware Health Information Network unveiled a new tool this week that aims to improve healthcare quality in the First State.


DHIN’s new Health Care Claims Database collects healthcare payment information from most entities that insure Delawareans. It is expected to help the state evaluate cost and quality of healthcare in Delaware, promote value-based and alternative payment arrangements and help support provider risk-sharing arrangements. 

According to Freedman Healthcare, the contractor that helped DHIN create the database, 18 other states have mandated claims databases like this one.

Freedman’s Tanya Bernstein says Delaware is the first state where insurance claims and clinical data are collected by the same agency.  “There is a great opportunity to get the holy grail of claims data and clinical data."

DHIN officials say linking the datasets allows for analyses about value of care — but that tweaks need to be made to contracts surrounding the clinical data first.

Officials also hope to link the claims data to census or other survey data.

Bernstein says the new claims database can be used to research population health, healthcare cost and utilization, quality, coverage or access. She showed results of sample analyses about diabetes, asthma and cancer screenings at a launch event this week.

“Looking at diabetes,” she said, “what’s interesting is the paid amount per person is higher for younger people although the prevalence is higher with age.”

The database does not capture healthcare transactions for those who receive services through the VA, Department of Correction, or the uninsured. However, DHIN CEO Jan Lee says the database will be reflective enough of the whole population to generate useful analyses.

The General Assembly authorized DHIN to develop and operate the claims database in 2016.

Raw claims data or custom analyses will be available by request for uses such as research.