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All U.S. employer health plans have dollars, many have euros, and some have crypto.
Just about all have claims data.
James Gelfand, the chief executive officer of the ERISA Industry Committee, wants employers, regulators and others to recognize that the plan information is a valuable form of currency.
Gelfand talks about the value of health claims data in a comment on efforts by the Employee Benefits Security Administration — an arm of the U.S. Department of Labor — to implement proposed compensation disclosure requirements for pharmacy benefit managers and other employer plan service providers.
Employers have had a hard time persuading some PBMs and third-party administrators to provide detailed plan claims data.
Gelfand argues in the comment that DOL officials have the authority to require plan service providers to hand the claims data over to the employers because access to the data is a form of compensation for the plan service providers.
Today, Gelfand writes, a plan administrator may sell anonymized, aggregated employer plan data to database managers, drug manufacturers or other entities.
"This service provider receives an economic benefit that would not exist but for the service provider's relationship with the plan," Gelfand says. "This economic benefit that is generated on account of the service relationship with the plan can appropriately be considered 'compensation' to the service provider."
Because access to the plan claim information is a form of compensation, DOL officials can apply new and existing compensation disclosure requirements to any access a plan administrator has to an employer plan's data, Gelfand argues.
Once DOL officials recognize that access to plan claim information is a form of indirect compensation, that will require the service providers to disclose the plan claim information to employer plan sponsors and other plan fiduciaries, Gelfand says.
Bolton's perspective: Bolton, a law firm, has also been talking about the view that health plan claim information is money.
Bolton looks at the changing status of plan information in a commentary with the title "Data is the new currency."
Plan information was always valuable, but it's becoming even more valuable now, in the age of artificial intelligence systems that consume vast amounts of training data, because health care technology firms need the data to train care management and care navigation tools, according to Bolton.
Employers should be conscious of their position as plan data owners and analyze the security of plan data and use of plan data carefully, Bolton says.
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