Massachusetts

In 2009, the Division of Health Care Finance and Policy (CHIA’s predecessor agency) began to collect detailed claims data from payers following earlier preliminary efforts. The project charter established the goal of administrative simplification: making the database a central resource for all state agencies needing claims-level data to support their missions. This focus was important to secure the support of the insurance carriers who would be submitting data to the MA APCD. While implementation of the MA APCD would require significant resource investment by the carriers, it would also reduce the proliferating—and sometimes conflicting—requests for carriers to submit data to different state agencies. The charter also called for enhancing the data to facilitate analysis and making the database widely available: to the public to help inform policy, to consumers to support health care purchasing decisions, and to physicians to support care management and coordination. Responsibility for the MA APCD was transferred to CHIA in November 2012 following its creation earlier that year.

Number of Commercial Sources of Claims Data

Sources and Status of APCD Data Collection

Payers

Commercial Payers

Third Party Administrators/Self-Funded

Medicaid

Medicare

Other

Types of Data Collected

Medical Claims

Eligibility

Dental

Pharmacy

Primary Users/Uses

1. Cost analysis
2. Enrollment monitoring
3. Facilitation of administrative simplification by serving as the central repository of health care claims data for Massachusetts state government agencies
4. Academic research

State Specific Resources

Contact Information

APCD Council