Proposal to merge clinical and claims data draws support and privacy questions

Brent Walker, representing the Medical Association of Georgia, introduced House Bill 102 as a proposal to standardize and combine clinical and claims data so Georgia can produce more accurate quality and opioid‑treatment metrics, particularly for Medicaid. "If we truly want to paint a picture of health care in the state of Georgia, especially within Medicaid, we must move beyond fragmented reporting and towards integrated outcome‑focused quality measurements," Walker said.

Frontline providers described the administrative burden of the current fractured reporting landscape. Mike Gable, CEO of McIntosh Clinic in Thomasville, said his clinic spends the equivalent of 52 staff hours a week on quality work outside direct patient care and described problems with patient attribution and delayed payer feedback. "We have payers that measure our quality based on claims data, which can run up to 12 weeks behind," he said, noting that duplicate work and inconsistent portals divert clinician time from patients.

Remote witnesses and researchers supplied examples and evidence. Austin Gillard (Clay County Medical Center, Kansas) described combining clinical and claims data locally to improve quality and financial stability for a rural system. John Demore (researcher/faculty) summarized research showing that integrated clinical data via health information exchanges improves the accuracy of quality measurement and reduces misleading results due to fragmented data.

Privacy and implementation concerns: Committee members pressed on privacy. Members asked about bill language (lines 64–66) dealing with personal identifiers and open records. Brent Walker said the bill envisions de‑identified data for quality reporting and HIPAA protections and emphasized safeguards to protect direct personal identifiers. Joe (chief operating officer, Department of Community Health) cautioned that Georgia's all‑payers database was built under agreements that remove personal identifiers, limiting the state's ability to do the type of enterprise‑level linking described by witnesses. "That dataset is problematic" to match externally, he said, and urged continued consultation between sponsors and DCH over the summer.

Next steps: Sponsors and witnesses agreed to continue technical work over the summer. Committee members welcomed examples of lower burden models but directed staff to work with DCH to assess legal constraints and technical feasibility before the committee takes further action.