Health Care Payments Data Program Submitters – HCAI

Mandatory Submitters#

The HPD Program has developed the following goals, based on the legislative intent outlined in the authorizing statute.

• Provide public benefit for Californians and the state while protecting consumer privacy.
• Increase transparency about health care costs, utilization, quality, and equity.
• Inform policy decisions on topics including the provision of quality health care, improving public health, reducing disparities, advancing health coverage, reducing health care costs, and oversight of the health care system and health care companies.
• Support the development of approaches, services and programs that deliver health care that is cost effective, responsive to the needs of enrollees, and recognizes the diversity of California and impacts of social determinants of health.
• Improve data transparency to achieve a sustainable health care system and more equitable access to affordable and quality health care for all.
• Learn about and seek to improve public health, social determinants of health, and the health care system, not about the individual patients.

Voluntary Submitters#

Many health benefit programs are increasingly concerned about the continued escalation of health care costs and are interested in more effective use of data and transparency to drive the development of solutions. An estimated 4-5 million Californians are covered by ERISA self-funded employers and other purchasers, which are not mandatory submitters under the HPD Program. These purchasers may choose to contribute their data to the HPD. The more comprehensive the HPD is in reflecting the entire population of California, the more accurate the analytic findings will be and the greater the likelihood of achieving both purchaser goals and HPD program goals – including transparency, informed policy decisions, improved health care, and equitable access to affordable and high-quality care.

Purchasers can request their ASO plan(s) that their data be submitted to HPD. Click below to request assistance connecting with your ASO.

What Can Employers Learn from HPD Data?#

The HPD Program has launched with the release of its first public report – the HPD Snapshot. The HPD Snapshot provides information about what data is available in the HPD System, including the number of Californians represented, types of health care coverage (e.g., commercial, Medi-Cal, Medicare), and most common procedures and prescription drugs.  

• This initial visualization allows users to view, at a glance, the most common services provided in the state, including the procedure category. Users can filter by type of service (e.g., inpatient, outpatient, home health), and by reporting year. 
• The report also displays the top drug prescriptions, along with the total number of prescriptions. The visualization includes filters for drug class (e.g., cardiovascular agents), whether the drug is brand or generic, and reporting year.

HCAI anticipates continuing to advance the accessibility and usefulness of HPD public reports as the database becomes more comprehensive and complete and HCAI builds its capacity over time.    

Submitter Group Meetings#

Pursuant to Section 127672 of the Health and Safety Code, HCAI is authorized to convene stakeholder committees or workgroups as necessary to support effective operation of the system. In addition to the statutorily mandated HPD Advisory Committee, HCAI convenes Submitter Group Meetings to provide a forum for HPD Data Submitters to receive up to date information on submission requirements, troubleshoot data submissions, and address any other technical issues as related to data submission.  

These meetings are intended for entities that are required to submit or are supporting the submission of data to the HPD System. If you are interested in learning more about joining the submitter group meetings, please email hpd@hcai.ca.gov describing your interest in attending.