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California Takes Another Step to Improve Health Care Costs, Quality, and Access for All Californians

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WHAT YOU NEED TO KNOW: In support of California’s efforts to reduce health care costs and disparities, as well as efforts to improve care, the state’s Health Care Payments Data Program, also known as an all-payer claims database, has been completed and includes data for 82 percent of Californians.

SACRAMENTO – The Department of Health Care Access and Information (HCAI) recently released its report to the California Legislature on the Health Care Payments Data (HPD) Program, also known as California’s All-Payer Claims Database (APCD). The Program features a research database that includes information submitted by payers, such as Medi-Cal, about medical services received by patients and payments for those services.

“The Health Care Payments Data Program is a vital tool in providing a better understanding of the care Californians are getting and who is paying for it across the state,” said HCAI Director Elizabeth Landsberg. “This program has already provided useful data reports that give a snapshot of health care consumption, utilization, health conditions and more. These data will also help inform the important work of other offices within HCAI, specifically the Office of Health Care Affordability.”

“Health care costs are continuing to spiral upward. California is putting in the hard work to address these costs through a series of initiatives and programs,” said California Health and Human Services Agency Secretary Dr. Mark Ghaly. “California’s All-Payer Claims Database is a tool that can help us identify the drivers of costs of care and how we can work to slow or reduce those costs.”

The legislative report delivered this month includes the following findings and next steps for the program:

  • The HPD system reflects approximately 82% of Californians and their health care services.
  • Efforts to expand the HPD Program are underway, including adding data from dental plans and insurers, capitation payments and other non-claims payment data.
  • The HPD Program’s public reporting and data release functions have been successful and continue to evolve.

See an executive summary of the report for more information.

Watch HCAI’s video on how the HPD system collects and reports data for more Information.

WHY THIS MATTERS: The information from the HPD Program is intended to support greater health care cost transparency and will be used to inform policy decisions regarding the provision of quality health care, and to reduce health care costs and disparities. Specifically, the information will be used to develop innovative approaches, services, and programs that may have the potential to deliver health care that is both cost effective and responsive to the needs of all Californians.

WHAT IT DELIVERS: The program has already released two data reports based on information received from payers. The first was the HPD Snapshot Report, which provides an overview of data and allows users to explore how many Californians received coverage from each type of payer and the number of medical or pharmacy service records generated. The second is the HPD Measures Report: Health Conditions, Utilization, and Demographics. The report’s health condition measurements show the prevalence of long-term illnesses and major medical events in California’s communities. The utilization measures present rates of health care system use through visits to the emergency room and different categories of hospitalization, such as pregnancy or surgical stays. The demographic measures describe the health coverage and other characteristics of California patients included in the data.  

To maximize its value for California policymakers, researchers, and others interested in improving California’s health care system, HCAI intends for the HPD to be as comprehensive and complete as possible by increasing the quality, volume, and variety of data collected over time. Later this year HCAI expects to begin accepting requests from researchers, analysts, and others to access non-public data from the database.

BIGGER PICTURE: California has taken several important steps to connect efforts that look to improve access to health care and reduce the cost of health care. The HPD and the newly established Office of Health Care Affordability (OHCA) build upon each other. The OHCA has been tasked with slowing health care spending, promoting high value system performance and assessing market consolidation. Additionally, these efforts are further connected by the work of the California Health and Human Services’ Data Exchange Framework, which looks to facilitate the secure and appropriate exchange of health and social services information, giving providers a clear understanding of a patient’s full health history and the information needed to provide safe, effective, and whole-person care.

For more information on the report, please see the HPD Program page post.