Utilization

Resource	Category	Carriers	Purpose
Maryland Medical Assistance Program and Health Insurance – Required Coverage for Menopause-Related Treatment, Care, and Training of Clinicians This report evaluates the use, cost, and insurance impact of menopause-related treatments—especially prescription drugs—within Maryland’s healthcare s... State: Maryland	Health Reform, Insurance Department	Commercial	Utilization
Using prescription medication utilization trends to evaluate health system resilience and inform future emergency preparedness The study examines how changes in prescription medication use during the COVID-19 pandemic can reveal strengths and weaknesses in the healthcare syste... State: Colorado	Population Health	Commercial, Medicaid, Medicare	Utilization
Evaluating the impact of health equity zones to mitigate disparities in cancer screening: study of colorectal cancer screening in rhode island This case study uses Rhode Island's all-payer claims database (HealthFacts RI) to evaluate whether the state's Health Equity Zones initiativ... State: Rhode Island	Population Health	Commercial, Medicaid	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
Novel approaches in linkage of data sources to explore the associations between purchase of opioid prescriptions during pregnancy and adverse neonatal outcomes This case study links Arkansas APCD and PDMP data to assess prescribed opioid exposure during pregnancy, demonstrating that combining both data source... State: Arkansas	Population Health, Researchers	Commercial, Medicaid	Utilization
Provider networks for pulmonary hypertension in Massachusetts: Implications for improving referrals to expert care This case study found significant gaps in connections to expert care, even among providers caring for patients at risk for pulmonary arterial hyperten... State: Massachusetts	Consumers, Medicaid, Population Health, Providers	Commercial, Medicaid, Medicare	Quality, Utilization
Reclassifying Primary Care: A Decision Tree Approach to Improving Workforce Estimates and Research Using Claims Data This case study uses Virginia APCD data to develop and validate a decision tree classifier for identifying primary care clinicians in claims data, fin... State: Virginia	Employers, Providers	Commercial	Utilization
Medicaid Reimbursement for Maternal Depression Screening and Care for Postpartum Depression This case study uses Colorado APCD data to evaluate the state's 2014 Medicaid reimbursement policy for postpartum depression screening during wel... State: Colorado	Medicaid	Commercial, Medicaid	Utilization
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

Utilization

APCD Council