The Promise of All-Payer Claims Databases

Health Highlights

All-Payer Claims Databases (APCDs) are some of our nation’s most powerful healthcare data assets, yet information about what they are, the populations and the types of data they include, and how they can be effectively deployed has been slow to reach potential users. Manatt Health’s first annual APCD Capacity Survey captured foundational statistics on the reach of state APCDs nationally as well as information on their most promising use cases. This research was conducted to provide policymakers, researchers and other potential users with a better understanding of how APCDs may be deployed to promote the “Triple Aim” in an increasingly data-driven program and policy environment, and was recently presented at AcademyHealth  (To see the full poster presented at AcademyHealth, click here.)

APCDs are powerful, emerging, centralized state databases that include medical, dental, and pharmaceutical health insurance membership and claims records for nearly two-thirds of their states’ populations across most insurance categories (Medicaid, Medicare Advantage, private commercial). Their breadth and depth of coverage make them an attractive resource for policymakers, researchers and other healthcare stakeholders for marketwide coverage, cost or utilization reporting; identifying access and use disparities; or conducting targeted research around distinct subpopulations. APCDs have the potential to be a key resource for a new generation of data-driven decision making.

Key findings from our survey included:

  • APCDs hold data for nearly two-thirds (62%) of state residents.
  • All APCDs collect data for private fully insured members, and more than three-quarters collect Medicaid and Medicare Advantage member data.
  • State APCD agencies’ most pressing concerns include maintaining funding in tight budgetary environments, and the usability of behavioral health and substance use disorder data.
  • APCDs have the potential to be significant resources for a new generation of data-driven policymakers and big data researchers. However, they remain developing assets, requiring continued investment and, most importantly, use to realize their promise.

APCDs currently hold data for more than 27 million people, and that number is expected to triple in the next five years, as New York, Florida and California bring new APCDs online to inform their future healthcare decision making.



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