Post Content

 David_morales Posted by: David Morales, Commissioner, Division of Health Care Finance and Policy

Health care costs are a critical issue facing the Commonwealth as individuals, families, and employers, as well as state and local government, are all struggling under the weight of high and rapidly rising costs of health care.  Without immediate action, economists estimate that the proportion of family income devoted to health insurance could rise to more than a third of median family income by 2016. This trend is unsustainable and underscores the need for immediate action in order to change this trajectory.

A little-noticed initiative is unfolding at the Division of Health Care Finance and Policy that will help to better inform businesses and consumers about health care costs and help them to understand what medical services cost and how much we pay for them in Massachusetts.  The Division is required by law to develop a robust health care claims database, which would offer full transparency.

Today, the Division will propose draft regulations to collect – in one central database – all inpatient, outpatient, pharmacy, and dental claims from fully-insured and self-insured health plans, Medicare, and Medicaid sources.  For the first time in the state’s history, this all-payer claims database – or APCD – will offer like never-before, a broad understanding of health care costs and medical service utilization across institutions and populations. 


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; and in that way help to lower costs by encouraging them to use high-quality, more efficient providers. 

An added benefit of an APCD is that it would help to lower administrative costs for both government and insurers because it could serve as the central point for all health care claims.  Today, multiple agencies make routine requests of such data and drive up unnecessary administrative costs that in turn add to the cost of premiums.

Lastly, the APCD will serve as a valuable resource for researchers and other private sector organizations who seek to develop efficient, innovative ways of delivering health care in low-cost, integrated settings.

As we prepare to hold public hearings in late spring, we welcome your participation, questions, and comments. For more information about the APCD public hearings, please visit www.mass.gov/dhcfp, subscribe to our electronic mailing list by emailing dhcfp.newsletter@state.ma.us, or follow us on Twitter at www.twitter.com/masshealthcare.

Written By:

Recent Posts

Getting to the Root of Some Tasty Vegetables! posted on Sep 29

Getting to the Root of Some Tasty Vegetables!

Fall is in full bloom with its wide selection of root vegetables available to our families! The truth is…these veggies that grow and sprout out of the dirt can be a little intimidating to some of us. They have a thicker skin, longer stems and   …Continue Reading Getting to the Root of Some Tasty Vegetables!

A Community Partnership to Prevent Falls Among Older Adults posted on Sep 24

A Community Partnership to Prevent Falls Among Older Adults

Each year in the United States, one out of every three adults age 65 and over experiences a fall. And in Massachusetts, every 13 minutes (on average) an older adult requires treatment in an emergency room for fall-related injuries. The human toll of these injuries   …Continue Reading A Community Partnership to Prevent Falls Among Older Adults

Declutter Your Space, Declutter Your Mind posted on Sep 24

Declutter Your Space, Declutter Your Mind

It can be hard to let go of things. Your favorite pair of jeans with big holes in the knees, those dusty books that have been on the shelf for years, or your old Beanie Baby collection from when you were a kid, for example.   …Continue Reading Declutter Your Space, Declutter Your Mind