Realizing the Promise of All Payer Claims Databases: A Federal & State Action Plan

Developed with the support of the Robert Wood Johnson Foundation

In 2020, health care spending in the United States increased by nearly 10 percent to reach $4.1 trillion, or 20 percent of the U.S. economy. Although the health care industry is foundational to the health and well-being of our nation and is powered by data, the policymakers, regulators and other public stakeholders charged with overseeing its efficacy often lack comprehensive and timely information about its operations and performance.

To address local information gaps, state policymakers and regulators from across the country—and across the political spectrum—have invested in all payer claims databases (APCDs), powerful repositories of health care claims and encounter data that can offer unique insights into local market dynamics and operations. Eighteen states presently have an APCD, and at least six others have an APCD in development. However, the current state APCD operating model was not intended to serve as a national health data blueprint and has several limitations that prohibit important local and national use cases.

As consumer health care cost growth accelerates in the wake of a national public health emergency, the importance of market transparency and having access to comprehensive health system data resources—for state and national users—has never been clearer. In a paper developed with the support of the Robert Wood Johnson Foundation, Manatt Health describes the value of APCDs in informing an emerging discussion among the federal government, states and health data leaders about the future of our systems of health and proposes investing in and building from our state health data infrastructure to develop national health data capacity. The paper includes:

  • Contextual information about state APCDs
  • The strengths and weaknesses of the current APCD operating model
  • An assessment of alternative models and recommendations for implementation

To read the full paper, click here.

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