Massachusetts
Category
Title or Name of APCD System
- Massachusetts All-Payer Claims Database
Who Maintains the System
- Massachusetts Center for Health Information and Analysis
Legal Authority
Submission Rules
Release Policy
First Year APCD Collected Data
- 2009
APCD Snapshot
- 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
- 52
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
- Collection of Product and Provider files
*Self-funded claims are Voluntary
Types of Data Collected
Medical Claims
- Currently Collected
Eligibility
- Currently Collected
Dental
- Currently Collected
Pharmacy
- Currently Collected
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
- For more information, please contact apcd.data@chiamass.gov
Use Cases from the APCD Showcase
Displaying 16 - 20 of 27
| Use Cases | Category | Carriers | |
|---|---|---|---|
The Center for Health Information and Analysis (CHIA)'s 2017 Annual Report on the Performance of the Massachusetts Healthcare System analyzes trends in state health care cost and quality to better inform policy makers. Key findings include an increase in total health care expenditures primarily driven by an increase in pharmacy and outpatient spending and an increase in the adoption of alternative payment methods, among other things. |
Employers, Health Reform, Insurance Department, Medicaid, Population Health, Providers, Researchers | Commercial, Medicaid, Medicare | |
The Massachusetts Center for Health Information and Analysis's (CHIA) annual report looks at the trends in health insurance enrollment from September 2015 through September 2017 for commercial, Medicare, and Medicaid beneficiaries. Data from the top 13 commercial payers and MassHealth is procured from the Massachusetts All-Payer Claims Database (APCD). Changes in enrollment by payer and funding type are considered. Overall, insurance coverage in Massachusetts remained steady during this two year period. |
Employers, Insurance Department, Population Health, Researchers | Commercial, Medicaid, Medicare | |
CompareCare's mission is to provide Massachusetts health care consumers the guidance and tools they need to become active partners in navigating their health care decisions. CompareCare's tools help Massachusetts health care consumers compare costs of medical procedures in different health care facilities and different cities, compare the quality of different hospitals and health care facilities, and make informed decisions about health insurance and health care. |
Consumers | Commercial | |
In the 2017 Annual Report on the Performance of the Massachusetts Health Care System, the Center for Health Information and Analysis (CHIA) identified trends in private commercial health insurance costs and coverage, with several major findings related to individuals who purchased commercial plans outside the employer-sponsored insurance system. |
Consumers, Employers, Population Health, Researchers | Commercial | |
Findings: In this cohort study of 1020 adults that used a combined instrumental variable analysis and matching approach, participation in a medically tailored meal delivery program was associated with approximately half the number of inpatient admissions. |
Consumers, Medicaid, Population Health, Providers, Researchers | Commercial, Medicaid, Medicare |