Question: Why are we one step forward toward greater transparency in the Massachusetts health care delivery system?
Answer: Today, the Division of Health Care Finance and Policy adopted regulations for the All-Payer Claims Database (APCD).
As I have mentioned in previous blog posts, the APCD will include virtually all health care claims data in Massachusetts. Not only will it support valuable analysis of the health care system, it will also offer consumers and employers a clearer picture and better understanding of the true cost of health care.
An added benefit of the APCD is that it will help to lower administrative costs for both government and health plans because it will serve as a central repository for health care claims. Today, multiple agencies make routine requests of such data and drive up unnecessary administrative costs.
Here's a quick overview of the two APCD-related regulations:
114.5 CMR 21.00 establishes data submission requirements for health care payers. Essentially, the APCD will serve as a clearinghouse for comprehensive quality and cost information that will help consumers, employers, insurers, and government have the necessary data to make prudent health care purchasing decisions.
114.5 CMR 22.00 governs the disclosure of all member eligibility and claims data. This will make health care claims data available for health care policy analysis that serves the public interest and safeguards the privacy rights of members.
Over the next several months, we will continue to update you on the progress of the APCD. Stay tuned to learn more.