Big Data: A New Paradigm for Health Plan Oversight and Consumer Protection?

An analysis of the reporting requirements for insurance company data under the Affordable Care Act (ACA) and interviews with key health insurance stakeholders identifies the benefits and challenges of using a big data approach.

The Issue

The ACA requires health plans to report a wide range of data that are intended to provide better oversight of insurer practices and improve consumer protections—but this requirement has yet to be implemented.

Key Findings

Advantages of big data include:

  • Understanding how patients with specific conditions fare under different plans;  

  • Helping regulators monitor and address market trends in real-time and at a granular level; and

  • Lowering the reporting burden on insurers.

Conclusion

Privacy and security concerns are among the biggest obstacles that researchers found. Researchers say there’s time to iron out the kinks, however, as the administration goes forward with implementing the ACA's data collection for transparency and oversight.

About the Grantee

The Center on Health Insurance Reforms at Georgetown University’s Health Policy Institute is a nonpartisan, expert team of faculty and staff dedicated to conducting research on the complex and developing relationship between state and federal oversight of health insurance markets.