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  • Nevada | APCD Council
    Us APCD Council Leadership Team Our Sponsors Toggle navigation Search form Search Search State Efforts APCD Legislation by State Claims Data Release Rules Claims Data Collection Rules Nevada Publications Data Requests Resources FAQs Standards Awards and Requests for Proposals Employment Opportunities Presentations Vendors Webinars Learning Network Meeting Notes Calendar Calendar Archive About Us APCD Council Leadership Team Our Sponsors State Efforts Nevada Nevada Category No Current Activity State Efforts APCD

    Original URL path: http://www.apcdcouncil.org/state/nevada (2016-04-30)
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  • Pennsylvania | APCD Council
    Our Sponsors State Efforts Pennsylvania Pennsylvania Category Strong Interest Who Maintains the System PHC4 Pennsylvania Health Care Cost Containment Council Website http www phc4 org Related APCD Activity The Pennsylvania Health Care Cost Containment Council PHC4 is taking steps toward collecting an all payer claims database As called for in its reauthorizing legislation PA Act 3 of 2009 PHC4 has reconstituted its Payment Data Advisory Group in an effort to move decisively and expeditiously forward on payment data collection analysis and reporting The group s membership is outlined in Act 3 and includes members representing health plans health care facilities and physicians Since its inaugural meeting in January the group has met a total of six times The tone and pace of the meetings have been positive and goal oriented PHC4 has reached beyond the group membership to engage stakeholder involvement at all levels Representatives from the purchaser community have shared their views on how PHC4 payment data could be beneficial to them The group has benefited enormously in hearing from a variety of experts and organizations including other states that have already developed successful systems of payment data collection analysis and reporting Hearing from these states has provided some

    Original URL path: http://www.apcdcouncil.org/state/pennsylvania (2016-04-30)
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  • West Virginia | APCD Council
    About Us APCD Council Leadership Team Our Sponsors State Efforts West Virginia West Virginia Title or Name of APCD System West Virginia Health Care Authority Database Category In Implementation Who Maintains the System West Virginia Health Care Authority Website http www hca wv gov Legal Authority Investment 200k invested in the development and analytics of APCD to date Statute http www legis state wv us bill status bills text cfm billdoc SB350 20SUB1 htm yr 2011 sesstype RS i 350 Submission Rules http www wvinsurance gov LinkClick aspx fileticket Xa1R jFZ6Cw 3d tabid 329 mid 889 APCD Snapshot The claims data in West Virginia were originally collected to answer policy questions Understanding cost was an important issue In addition Public Health was very interested in geographic variation in health status and incidence of chronic disease Additionally Health Policy planners were interested in evaluating the development of managed care Number of Commercial Sources of Claims Data 3 Sources and Status of APCD Data Collection Payers Currently Collected Planned Collection Commercial Payers Yes Third Party Administrators Self Funded Yes Medicaid Yes Types of Data Collected Currently Collected Planned Collection Medical Claims Yes Eligibility Yes Dental Yes Pharmacy Yes Primary Users Uses Analyses

    Original URL path: http://www.apcdcouncil.org/state/west-virginia (2016-04-30)
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  • Florida | APCD Council
    Rules Florida Publications Data Requests Resources FAQs Standards Awards and Requests for Proposals Employment Opportunities Presentations Vendors Webinars Learning Network Meeting Notes Calendar Calendar Archive About Us APCD Council Leadership Team Our Sponsors State Efforts Florida Florida Category Strong Interest Who Maintains the System Florida Agency for Health Care Administration Website http ahca myflorida com Related APCD Activity Florida is interested in an APCD but no definite plans exist at

    Original URL path: http://www.apcdcouncil.org/state/florida (2016-04-30)
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  • Maine | APCD Council
    Claims Database Category Existing Who Maintains the System Maine Health Data Organization Website http mhdo maine gov imhdo Legal Authority Investment 4 5 million across MHDO MHDPC for hardware and staff time since 2002 Compliance and resubmissions for failed edits are time intensive especially at first States that use a common format harmonize with other states will reduce start up and reporting Statute http www mainelegislature org legis statutes 22 title22sec8703 html Submission Rules https mhdo maine gov claims htm Release Policy https mhdo maine gov claims htm First Year APCD Collected Data 2003 APCD Snapshot Maine Health Data Organization Maine Health Management Coalition and the Maine Health Info Center leveraged a voluntary aggregation pilot into a statewide initiative Large employers needed cost data as well Carriers were interested in a broader view of utilization across the system Hospitals wanted a payment website Number of Commercial Sources of Claims Data 89 Related APCD Activity Q1 2014 APCD Data was released 8 5 14 This included commercial claims and MaineCare data Sources and Status of APCD Data Collection Payers Currently Collected Planned Collection Commercial Payers Yes Third Party Administrators Self Funded Yes Medicaid Yes Medicare Yes Other Psuedo claims for some

    Original URL path: http://www.apcdcouncil.org/state/maine (2016-04-30)
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  • New Hampshire | APCD Council
    New Hampshire Comprehensive Healthcare Information System began accepting claims submissions in 2005 in response to a need for more transparency in the commercial insurance system The drivers listed in their statute include the provision of a resource for continuous review of health care utilization expenditures and performance data by insurers purchasers employers providers and state agencies Also expressed was the goal to help consumers and employers make informed and cost effective health care choices In addition data were desired for comparison to Medicaid quality cost utilization and price Number of Commercial Sources of Claims Data 26 Sources and Status of APCD Data Collection Payers Currently Collected Planned Collection Commercial Payers Yes Third Party Administrators Self Funded Yes Medicaid Yes Medicare Yes Types of Data Collected Currently Collected Planned Collection Medical Claims Yes Eligibility Yes Dental Yes Pharmacy Yes Other Also planned is the collection of some form of uninsured claim information Primary Users Uses For the NH Department of Health and Human Services Office of Medicaid Business and Policy OMPB the reporting agenda is focused on how health care quality access use and cost vary geographically between providers and most importantly between the Medicaid covered and commercially insured populations as well as benchmarking of payment rates The NHID is using the claims data to better understand the health insurance market in New Hampshire as well as to provide New Hampshire residents with information about the cost of health care services To date the NHID has developed the NH HealthCost website for insurers and is in the process of developing a second website for employers Future Plans None at this time Consumer Website http www nhhealthcost org State Specific Resources NH CHIS Newsletter June 2013 NH CHIS Newsletter December 2012 A Commercial Insurance Study of Vaginal Delivery and Cesarean Section Rates

    Original URL path: http://www.apcdcouncil.org/state/new-hampshire (2016-04-30)
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  • Rhode Island | APCD Council
    Island Department of Health the Office of the Health Insurance Commissioner the Health Benefits Exchanges and the Executive Office of Health and Human Services Website http health ri gov data healthfactsri Legal Authority Statute http www rilin state ri us Statutes TITLE23 23 17 17 23 17 17 9 HTM First Year APCD Collected Data 2010 APCD Snapshot Legislation establishing an APCD was passed in 2008 Because the statute did not provide funding for the Department of Health to develop and operate an APCD the state has mobilized a series of federal grants to support start up operations Following the end of these federal grants the project s four partner agencies Medicaid the Health Insurance Exchange the Office of the Health Insurance Commissioner and the Dept of Health will commit funding and staff to the ongoing operations of the APCD The RI APCD will be used to ensure transparency of information about the quality cost efficiency and access of Rhode Island s healthcare delivery system It will also provide state agencies and policy makers with the information they need to improve the value of healthcare for Rhode Island residents Data is expected to be available in early 2015 Sources and Status of APCD Data Collection Payers Currently Collected Planned Collection Commercial Payers Yes Medicaid Yes Medicare Yes Types of Data Collected Currently Collected Planned Collection Medical Claims Yes Pharmacy Yes Primary Users Uses Medicaid Dept of Health Health Insurance Commissioner and the Health Insurance Exchange Future Plans The data gathering process will begin in January 2014 with data submission scheduled to begin in May 2014 The plan as of January 2014 calls for the release of a Request for Proposals for Analytics March April of 2014 State Specific Resources 3M Awarded Analytics Contract for Rhode Island s All Payer Claims

    Original URL path: http://www.apcdcouncil.org/state/rhode-island (2016-04-30)
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  • Wisconsin | APCD Council
    Website http www wisconsinhealthinfo org Legal Authority Investment 4 million includes staff contracts legal Submission Rules Standardized file format twice annually medical pharmacy membership provider files First Year APCD Collected Data 2006 APCD Snapshot The Wisconsin Health Information Organization WHIO was voluntarily created in 2005 by members made up of providers employers payers and the state to improve the transparency quality and efficiency of healthcare in Wisconsin WHIO members and subscribers use the data to identify gaps in care for treatment of chronic conditions and provide real world data about the costs per episode of care population health preventable hospital readmissions variations in prescribing patterns and much more WHIO releases two updates each year often adding new data contributors with each release As of the last release DMV13 the WHIO Datamart contains 308 million claims for care provided to more than 4 1 million residents in Wisconsin 72 of the population exceeding 80 billion in billed charges Number of Commercial Sources of Claims Data 16 Sources and Status of APCD Data Collection Payers Currently Collected Planned Collection Commercial Payers Yes Third Party Administrators Self Funded Yes Medicaid Yes Medicare Yes Other Medicaid FFS and HMO data are collected Types of

    Original URL path: http://www.apcdcouncil.org/state/wisconsin (2016-04-30)
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