Maine
Category
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
Statute
Submission Rules
Release Policy
Data Request Process
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

Use Cases from the APCD Showcase

Displaying 6 - 8 of 8

Use Cases Category Carriers
Prescription Use among Children with Autism Spectrum Disorders in Northern New England: Intensity and Small Area Variation
This report measures the intensity of prescription use and regional variation of psychotropic and two non-psychotropic drugs among children with autism spectrum disorders (ASD) compared with children in the general population (House). Data is obtained from ambulatory prescription fills in Maine, New Hampshire, and Vermont all-payer administrative data, 2007-2010.
 Consumers, Population Health, Providers, Researchers Commercial, Medicaid
CompareMaine
CompareMaine, formerly known as Maine HealthCost, is a website which allows consumers to view the average cost of common medical procedures across different hospitals in the state. Users can also compare quality scores for the hospitals. Price information is based on paid claims data collected from Maine's commercial health insurers by the Maine Health Data Organization (MHDO).
 Consumers, Employers, Insurance Department, Providers Commercial
The New England States’ All-Payer Report on Primary Care Payments
The purpose of this report is to use standardized data to identify the percentage of all-payer primary care spending relative to overall healthcare spending in each state and to provide a framework to evaluate whether the states’ investments in primary care reflect the importance and value of primary care in each state.
 Consumers, Health Reform, Insurance Department, Medicaid, Providers, Researchers Commercial, Medicaid, Medicare