HPD Data Access and Release

About#

Assembly Bill 80 (Chapter 12, Statutes of 2020) provides HCAI the authority to establish the Health Care Payments Database (HPD) Program. The Health Care Payments Database (HPD) is California’s All Payer Claims Database or APCD. The HPD is a research database comprised of healthcare administrative data: claims and encounters generated by transactions among payers and providers on behalf of insured individuals. The HPD collects claim and encounter data as submitted from California payers.

The information from the HPD System 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. It is also intended for the information to 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.

To maximize its utility and value for California policymakers, researchers, and others interested in improving California’s healthcare 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.

Available Data Files#

The following is a list of data files available for request for years 2018-2023. The HPD uses the APCD Common Data Layout for file formats, which includes all of the data elements available in the database. Potential applicants should review the data layout in preparation for submitting their application.

Medical Claims

This data file contains medical claims and encounters data for primary and specialist care, outpatient surgeries, inpatient stays, and laboratory testing. This also includes data for home health care and nursing home care. Diagnoses, procedures, charged amounts, and paid amounts (plan and consumer paid amounts) data is also included.

Pharmacy Claims

This data file contains pharmacy data, such as drug names, quantity dispensed, charged amount, paid amounts (plan and consumer paid amounts). Provider and pharmacy information including name, specialty, location, and mail-order data is also included.

Member Eligibility

This data file contains member identifiers, age, gender, and location data.  Payer/health plan information, assigned primary care provider (PCP), and enrollment in person-centered medical home (PCMH) data is also included.

Provider Information

This data file contains provider identifiers, taxonomy/specialty, and location data.

Methods of Access#

There are two ways data applicants can access non-public data: via (1) the HCAI Secure Data Enclave or (2) Direct Transmission. The HPD statute contemplates that use of HPD data in the secure data enclave is the preferred way to safely access HPD data and that access to data outside of the secure data enclave should be limited, such as if the use of the data could not reasonably be achieved by accessing the data through the enclave. 

Secure Data Enclave#

The Secure Data Enclave is a centralized service for 24/7 remote access to sensitive data. It houses the data in a secure environment, protected in accordance with state and federal security and privacy rules, where it can be accessed via a virtual machine launched from the user’s computer. The Enclave comes equipped with a suite of statistical tools and provides scalable computing power to perform analysis on a high volume of data. Datasets can only be downloaded from the Enclave after they have been properly de-identified and after HCAI administrator review and approval is granted. 

Direct Transmission#

Direct Transmission is a method where HCAI sends copies of program data outside the secure data enclave directly to an individual or organization. Request for Direct Transmission of data will only be provided after a recommendation of approval by the HPD Data Release Committee. 

Uses of HPD Data#

Can HPD data be used to answer your policy or research question?#

HPD can be used to answer questions related to health care delivered to insured California patients and on topics related to:

• Systematic trends, such as comparing payers or counties
• Operational elements of the healthcare system, such as the utilization or cost of conditions and procedures
• Cost analyses based on claims data

The HPD cannot be used for:

• Research about individual patients, the uninsured population, people who self-pay for health services, or about populations residing outside of California
• Research requiring clinical information such as medical chart notes or lab results
• Cost analyses based on non-claims data. Read more about HCAI’s efforts to add non-claims payment information to the HPD. 

Informational Webinar#

Join us on January 15, 2025, for an informational webinar for researchers, state agencies, and other qualified applicants to hear from HCAl staff about the just-released HPD data request process, including how to access the data requests, dataset meanings, and application review timelines. HCAl staff will provide a brief presentation then respond to pre-submitted questions from attendees.

HCAl encourages attendees to submit questions in advance, preferably through the webinar’s registration form or by email at DataAndReports@hcai.ca.gov.

• HPD Data Access and Release Webinar Agenda

FAQs#

Who is eligible to request HPD Data? 

Any individual or organization is eligible to request HPD Data, including but not limited to state agencies, non-profit research institutions, non-profit educational institutions, hospitals, physician organizations, labor unions, self-insured employer plans, and consumer organizations.  

How can I apply to access HPD data? 

To start your application to access HPD data, please register on the HCAI Data Request Portal. Then, please submit a detailed application, answering the questions to the best of your ability and attaching necessary documentation. HCAI will then contact you for next steps.  

How will I receive my data? 

Dependent upon the nature of the request, you will receive the data through the Secure Data Enclave or Direct Transmission.  

What is the HCAI Secure Data Enclave? 

The HCAI Secure Data Enclave is a centralized service to remotely access sensitive data. It houses data in a secure environment and protects that data in accordance with state and federal security and privacy rules. The Enclave provides a scalable environment, and software tools, so a user can analyze a large volume of data regardless of their personal computer and storage resources. Data in the Enclave is accessed via a virtual machine operating on a remote server and launched from the user’s computer. The virtual machine is controlled by HCAI so that data products created on it can only be downloaded to the user’s computer with HCAI’s permission. Users cannot copy/paste, email out, or otherwise remove data from the Enclave. Only after HCAI verifies that the data products align with the user’s approved request and with CalHHS Data De-Identification Guidelines can they be downloaded to the user’s computer. 

A user’s experience in the Enclave is tailored to their data request. HCAI’s Enclave makes the approved data available to approved users for approved projects. The data for each project in the Enclave is segregated from other projects’ data. Authorized users can upload and link their own datasets into the Enclave and link their data to the HPD dataset. Enclave users will have access to interactive, query-based tools, and statistical tools (e.g., SQL, SAS, Stata, R, Python). 

Standard Limited Datasets, Standard Limited Plus Datasets, Custom Limited Datasets, and Research Identifiable Data is available through the Enclave.  

What is Direct Transmission? 

Applicants approved for Direct Transmission will receive copies of HPD datasets outside of the Enclave, via a secure file transfer program.  

To receive Direct Transmission, the applicant must describe why the HCAI Data Enclave does not meet their needs.  

Standard Limited Datasets, Custom Limited Datasets, and Research Identifiable Data are available through Direct Transmission.  Standard Limited Plus Datasets are not available through Direct Transmission.

What am I allowed to do with the data? 

You may use the data only for the purposes described in the approved data request and signed Data Use Agreement.  

YOU MAY NOT: 

• use the data for a different project.  
• use someone else’s approved data for your own project. 
• share the data with anyone not explicitly listed in the HCAI request form and Data Use Agreement. 
• publish aggregated HPD data that includes cell size counts less than 11. 
• change your scope of work in your protocol or your HCAI request form without proper approvals. 
• keep HPD data in your system after the project has ended. 

Why are there additional restrictions on research identifiable datasets, direct transmission access, and access to Medi-Cal data? 

Additional restrictions are placed on research identifiable datasets because they contain sensitive information. Additional restrictions are placed on direct transmission because data use is more difficult to control outside of HCAI’s Secure Data Enclave. Additional restrictions are placed on Medi-Cal data because use of that data must be approved by DHCS (Department of Health Care Services) and meet the requirements of the Medi-Cal program. 

How long does it take to get approved for HPD data access? 

The approval process for HPD application can vary for each request type. HCAI’s goal is to process and approve data requests in 120 days. However, this depends on multiple factors including responsiveness of the requestor, level of detail included in the application, type of data requested, and mode of accessing the data. Requests for commercial-only Standard Limited Datasets accessed via the secure data enclave will have the quickest turnaround time.  

What does the application review process look like? 

All applications will be reviewed by HCAI, with additional levels of review for more complex requests. Applications requesting Medi-Cal data, research identifiable data, or direct transmission access will require further review from the Department of Health Care Services, the HPD Data Release Committee, and/or the Committee for the Protection of Human Subjects, as appropriate.

What is the role of the HPD Data Release Committee?  

The HPD Data Release Committee was established by state law to advise HCAI on issues of data privacy and security and to review specified applications for non-public data. The Data Release Committee is made up of health care payers, providers, purchasers, researchers, consumers, and labor with knowledge and experience with health care data, privacy, and security.

The Data Release Committee has enacted a HPD DRC Manual, which includes the DRC Considerations for Application Review that committee members will apply in reviewing data requests. Applicants may wish to review the manual to assist in developing their data request. 

Do I need approval from CPHS for my project?  

For Research Identifiable datasets, HPD requires approval of data applicant’s project by the Committee for the Protection of Human Subjects (CPHS). The CPHS is a state entity outside of HCAI and is currently administered by the California Health and Human Services Agency’s Center for the Data Insights and Innovation.  

Which should I submit first, my CPHS application or my HCAI application? 

For requests that require CPHS approval, we recommend that you do both processes in tandem. You will submit to HCAI a draft of your CPHS protocol as you go through HCAI’s preliminary review of your request, after which HCAI will provide you a pre-CPHS Letter of Acknowledgement. You will need to submit the pre-CPHS letter to CPHS as the departmental letter of support, which is required for CPHS approval. Once you receive CPHS approval, you will need to notify HCAI and upload the CPHS Approval Letter before HCAI’s final approval of your request.

To ensure the HPD data request process is not unduly delayed, please confirm information submitted to CPHS is consistent with information submitted to HCAI. 

Why is there a cost for accessing HPD data? 

The HPD statute contemplates data user fees as a component of HPD program funding. HCAI uses money received from data requestors to cover the associated costs to administer and operate the HPD program and to provide data to users. To best serve those interested in the HPD program, HCAI will need to develop a long-term funding mechanism to sustain the program. In March 2023, HCAI submitted a report to the Legislature on recommendations for funding options for the program. Read the funding options report.

When will dental claims and non-claims payments data be collected and available? 

Dental claims data will be collected beginning in 2024, while non-claims payments data will be collected beginning in 2025.

What are tips for a successful application? 

• The top of the application will allow you to select the type of data you are requesting (Limited, Custom or Research) and the requested data access method (Enclave or Direct Transmission). These selections will change the content of the form appropriately.
• Be sure to fill out all fields in the application form with complete details.  
• You will be required to indicate which HPD goals your application aligns with or offers significant opportunities to achieve. The goals of the program can be found here.
• Indicate if your organization submits data to the HPD program under Organization Information.  
• If you are requesting Research Identifiable Data or Custom Limited Data, complete the Justification Grid beforehand so you can attach it to the application. For more information on the Justification Grid, please visit here.
• If appropriate for your request, complete and upload a draft of the CPHS Protocol and attach to your data request form in the HCAI data request portal. 
• All individuals who will have access to the HPD data must be listed in the Data Access table.  
• Requests for secure data enclave access must complete the Data Users table, for the setup of each data user’s account within HCAI’s Secure Data Enclave environment.  
• If you plan to utilize external datasets with the requested HPD data, include information about those datasets in the Linkage section of the application form. 
• To ensure data security guidelines are in alignment, please visit HCAI’s Security Guidelines.
• Once you complete your application and pay the application fee, you will be brought to a page that will show your application status and state “CSXXXXXXX Created”. This is your case number. Please save this for future reference. 
• Familiarize yourself with the Data Release Committee Board Manual for considerations that committee members will apply in reviewing data requests.
• To reduce turnaround time for the data request, please be responsive to any questions or comments from HCAI.  

How do I contact HCAI if I am having problems registering in the HCAI Data Request Portal, or I have questions before starting my application?

If you are having problems registering in the data request portal or have questions before starting your application, please email dataandreports@hcai.ca.gov.