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Where data stops: employers want more data for cost planning, but where do they draw the line on privacy?

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THE U.S. HEALTHCARE system continues to struggle with costs, and ere are few lights at the end of the tunnel. As costs have climbed, data needs among employers are changing swiftly.

Desperate for an advantage, some employers are asking their health plan providers for deeper, more telling employee health information, only to find that they aren't able to obtain it because of HIPAA and similar laws.

Blaine Bos, worldwide partner in the health and benefits division of Mercer, consults with employers of all sizes. He says data needs vary considerably by size and complexity of employer. For instance, the large employer with employees scattered across several states will be seeking detailed data and may drill down to smaller categories of information.

"They can identify at that level conditions, drugs and treatments that have been offered, and can aggregate all patients in one grouping," Bos says. "You'd want that level of data if you're a large employer and have a robust chronic-condition management program or health questionnaire. In contrast, to help manage the smallest employers' data, data collection is minimal; it's more about the price of the premium this year."

Data mining skeptics such as Deborah Peel, psychiatrist, founder and chair, Patient Privacy Rights Group (PPRG), sees such mining as undermining consumers' rights to privacy.

"For one, it's almost completely impossible to de-identify health data," she says. "It's so rich in details that if they have year of birth or ZIP code, you could easily be re-identified."

Bos of Mercer disagrees. With HIPAA protections, he believes benefit information is fully encrypted.

"You can't determine whether this is Suzie Jones or Don Knotts," he says.

Peel points out that patient protections aren't as iron dad as they were originally intended to be. Prescription records have been sold for the last decade to insurers and large employers.

"One prescription data...

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