Cost

Resource	Category	Carriers	Purpose
Fragmented Financing in Emergency Department Use Among US Veterans This study found that emergency care for U.S. veterans is often fragmented because many veterans receive emergency department services that are paid f... State: New York	Insurance Department, Population Health, Researchers	Commercial, Medicaid, Medicare	Cost, Utilization
Curbing the Growing Fragmentation of Veterans' Health Care This article discusses how healthcare for U.S. veterans is becoming increasingly fragmented as more care is delivered outside the Veterans Health Admi... State: New York	Health Reform, Population Health	Commercial, Medicaid, Medicare	Cost, Quality, Utilization
Gender-Affirming Chest Masculinization and Nipple–Areolar Complex Reconstruction: An All-Payer Claims Database Analysis This study analyzed 912 gender-affirming chest masculinization surgeries performed in Massachusetts between 2016 and 2020 and found that 70% included ... State: Massachusetts	Population Health, Researchers	Commercial, Medicaid	Cost, Utilization
Rising Health Care Costs in Wisconsin: The Case for Price Transparency The report highlights growing financial and operational challenges facing healthcare organizations in 2026, including policy uncertainty, increasing c... State: Wisconsin	Health Reform, Researchers	Commercial	Cost
Health Insurance Claim Denials The article explains that health insurance claim denials are becoming increasingly common in the U.S., affecting everything from preventive care to ma... State: Massachusetts	Consumers, Insurance Department, Researchers	Commercial, Medicare	Cost, Quality, Utilization
Kidney Screening Care Coverage Analysis The report supports preventive kidney screening coverage as a cost-effective public health strategy that could improve early diagnosis, reduce severe ... State: Colorado	Health Reform, Insurance Department, Population Health	Commercial	Cost, Utilization
Maryland Medical Assistance Program and Health Insurance – Required Coverage for Aesthetic Services and Restorative Care for Victims of Domestic Violence This mandate study uses Maryland's All-Payer Claims Database (APCD) to estimate the fiscal impact of requiring Medicaid and commercial insurers t... State: Maryland	Consumers, Health Reform, Insurance Department	Commercial, Medicaid	Cost, Utilization
Corporate Moral Hazard In U.S. Health Insurance: Churn And Denial Rates This dissertation uses the New Hampshire APCD to examine whether commercial insurers increase claim denial rates ahead of the predictable transition t... State: New Hampshire	Health Reform, Insurance Department, Researchers	Commercial, Medicaid, Medicare	Cost, Utilization
County-level medical debt and treatment initiation among individuals newly diagnosed with cancer This case study examined the relationship between county-level medical debt and timely cancer treatment initiation, finding that patients in counties ... State: Colorado	Health Reform, Population Health, Providers	Commercial, Medicaid, Medicare	Cost, Quality
Aligning Incentives or Gaming the System? The Impact of Insurer-Physician Acquisitions This case study uses Colorado APCD data to examine a 2017 insurer-physician acquisition, finding that integration inflated Medicare Advantage diagnosi... State: Colorado	Health Reform, Insurance Department, Researchers	Commercial, Medicare	Cost, Utilization

Cost

APCD Council