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 21 - 25 of 27
| Use Cases | Category | Carriers | |
|---|---|---|---|
This study uses data from the Massachusetts APCD. Researchers found found eight touchpoints which were associated with increased risk of fatal opioid overdose, and collectively identified more than half of opioid overdose decedents. These touchpoints are potential targets for development of overdose prevention interventions. |
Health Reform, Population Health, Researchers | Commercial | |
This is the second study on prescription drug use and spending released from CHIA. For this analysis, CHIA used a subset of commercial pharmacy claims from the agency’s APCD to identify high volume and high cost drugs between 2015 and 2017. |
Consumers, Health Reform, Researchers | Commercial | |
A research study that measures special care days (SCDs) (intermediate or intensive), length of stay, and readmission rates among low-risk neonates across regions within 2 states using claims data. |
Providers, Researchers | Commercial | |
Analysis linking Massachusetts' All-Payer Claims Database with Massachusetts Cancer Registry data to assess factors associated with BRCA1/2 testing among young women with breast cancer in Massachusetts, a state with high levels of access to care and equitable insurance coverage of breast cancer gene (BRCA) testing. |
Consumers, Employers, Population Health, Providers, Researchers | Commercial, Medicaid | |
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 |