Maine
Title or Name of APCD System
- Maine Health Care Claims Database
Who Maintains the System
- Maine Health Data Organization
Website
Legal Authority
Investment
- $4-5 million across MHDO/MHDPC for hardware and staff time since 2002. Compliance and resubmissions for failed edits are time-intensive, especially at first. States that use a common format/harmonize with other states will reduce start-up and reporting
Submission Rules
Release Policy
First Year APCD Collected Data
- 2003
APCD Snapshot
- Maine Health Data Organization, Maine Health Management Coalition and the Maine Health Info Center leveraged a voluntary aggregation pilot into a statewide initiative. Large employers needed cost data as well. Carriers were interested in a broader view of utilization across the system. Hospitals wanted a payment website.
Number of Commercial Sources of Claims Data
- 89
Sources and Status of APCD Data Collection
Payers
Commercial Payers
- Currently Collected
Third Party Administrators/Self-Funded
- Currently Collected
Medicaid
- Currently Collected
Medicare
- Currently Collected
Other
- Tables of payer homegrown diagnosis/procedure codes; taxonomy code/physicians
Types of Data Collected
Medical Claims
- Currently Collected
Eligibility
- Currently Collected
Dental
- Currently Collected
Pharmacy
- Currently Collected
Other
- Psuedo-claims for some uninsured
Primary Users/Uses
- Analyses of cost, quality, system utilization, episodes, and geographical differences.
Consumer Website
Contact Information
For more information please contact Karynlee Harrington at Karynlee.harrington@maine.gov.