UTHealth Houston becomes go-to resource for health cost clarity

Texans won a major victory for health cost transparency in June with the conclusion of the 89th Texas Legislature, which provided funding support to the Texas All-Payor Claims Database and established the Health Impact, Cost, and Coverage Analysis Program (HICCAP) — both housed at UTHealth Houston School of Public Health’s Center for Health Care Data.

“This is an important step forward for the state in applying real, contemporary data to guiding health policy,” said Eric Boerwinkle, PhD, MS, MA, dean of UTHealth Houston School of Public Health, M. David Low Chair in Public Health, Kozmetsky Family Chair in Human Genetics, and professor of the Center for Human Genetics and Department of Epidemiology.

Why this is important

The Texas All-Payor Claims Database was created in 2021 with the passage of House Bill 2090 by Speaker and Rep. Dustin Burrows and former state senator and acting Comptroller Kelly Hancock to improve health cost transparency for Texans. However, it did not receive state funding in the 2021 or 2023 sessions, leaving its infrastructure and public-access portal incomplete. During its latest session, the Legislature appropriated funding for the database’s biennial operation.

By itself, this funding is a major boost for the database and to health cost transparency. But the Texas Legislature also passed House Bill 138 to establish HICCAP, a program that analyzes fiscal and health impacts of proposed insurance mandates before they are enacted into law. 

Through the establishment of HICCAP, health care data can now be used as a foundational source to inform legislative analysis on the effects of proposed health insurance laws, providing lawmakers with evidence-based assessments to improve transparency, planning, and effective health care services and treatments.

Together, both initiatives make UTHealth Houston the official go-to resource for Texas lawmakers who need objective, data-driven analysis on how proposed health insurance mandates affect costs for consumers and insurers, health service utilization, and public health outcomes.

Texas All-Payor Claims Database

The Texas All-Payor Claims Database is a large, statewide data system that identifies cost drivers through the capture of billions of medical and pharmacy claims from a wide range of payers — private insurance companies, Medicaid, Medicare, and some self-funded employer health plans.

Now fully funded, the center will use the database to create a public access portal for Texans to search and review health care information and reports on a regional and statewide basis, allowing them to make more informed decisions about their health care — leading to reduced costs and better health outcomes. The database will also provide a valuable source of information for qualified research entities in analyzing and improving health care services and general public health objectives, such as reducing chronic disease. 

“The center is ready and excited to tackle this new challenge,” said Cecilia Ganduglia-Cazaban, MD, DrPH, director of the Center for Health Care Data. “This initiative empowers researchers, policymakers, and communities with insights needed to improve care, reduce costs, and advance our understanding of the health of Texas.”

Main purposes

• Increase transparency in health care costs and quality.
• Support evidence-based policymaking by giving lawmakers and agencies better insight into health spending, utilization, and trends.
• Provide data access to qualified researchers to identify ways to improve population health, reduce costs, and address variations in care.
• Inform consumers by enabling public tools that compare costs and quality across providers.

The recent state funding marks the transition of the database from an aspirational project into a fully realized, operational resource, enhancing its capabilities by supporting data collection, analysis, and public access to health care claims information.

With both funding and statutory mandates backing it, the Texas All-Payor Claims Database is now better equipped to inform health policy decisions.

Health Impact, Cost, and Coverage Analysis Program

HICCAP is a new, state-mandated role for UTHealth Houston, specifically UTHealth Houston School of Public Health, which will house and run the program.

Intended to close a key information gap in health care legislation, the program will provide cost transparency and impact analysis. It will build on the state’s efforts to enhance health care affordability and policy evaluation by giving policymakers — and the public — an evidence-based tool to understand how new health-related mandates will affect insurance costs, access, and outcomes.

HICCAP will evaluate how proposed laws, especially those adding insurance mandates, impact coverage costs, public health outcomes, and service use.

“When legislators consider new insurance mandates, it’s essential they have access to real, comprehensive data to understand the full impact on health outcomes, costs, and health care utilization,” said Trudy Millard Krause, DrPH, co-founder of the Center for Health Care Data. “HICCAP ensures that these decisions are informed by evidence, not assumptions — empowering policymakers to make choices that truly benefit Texans.”

Funding for HICCAP is through annual fees on health benefit plan issuers, which means dedicated, recurring financing for staff, data infrastructure, and ongoing analyses.

For plans like ERS and TRS, which require ongoing support to control premiums, the Texas All-Payor Claims Database and HICCAP offer a path toward smarter, more sustainable health plan design.