The Department of Health Care Access and Information (HCAI) March HPD Program Quarterly Newsletter is designed to keep stakeholders informed on programmatic updates and ongoing stakeholder engagement.
HPD Program Updates
Public Reporting
Medical Out-of-Pocket Costs and Chronic Conditions in 2022
HCAI published the Medical Out-of-Pocket Costs and Chronic Conditions in 2022 Report. This report provides an in-depth look at the financial responsibility for medical care experienced by Californian consumers in 2022. It focuses on cost-sharing out-of-pocket (OOP) expenses—the costs of covered medical services that are not reimbursed by insurance but are instead paid by consumers. These include the deductibles, co-payments, and co-insurance associated with medical care. Three metrics—the annual median OOP cost per member, the number of members (unique individuals) with at least one medical visit, and the annual median number of claims per member—and can be viewed, for the entire state and by county. In addition, these can be examined separately for 23 specific chronic conditions and compared between Californians who do not experience any chronic conditions, those who live with one condition, and those who have to manage multiple.
Data Access and Release
The HPD Program Data Use, Access, and Release Regulations were approved by the Office of Administrative Law and filed with the Secretary of State on November 25, 2024. The regulations can be found on the HPD Program webpage under the “Laws and Regulations” section.
This critical step paves the way for the official opening of applications, allowing researchers, state agencies, and other qualified applicants to access non-public HPD data.
To apply for HPD datasets, please begin by registering an account on HCAI’s Data Request Portal. Then complete and submit a detailed application, including a description of your research, data needs, and privacy measures. Visit HCAI’s HPD Data Access and Release webpage for more information.
On January 15, 2025, HCAI held an informational webinar for researchers, state agencies, and other qualified applicants to hear from HCAI staff about the HPD data request process, including how to access data requests, dataset meanings, and application review timelines. Materials from the webinar, including responses to all questions received, are available on the HPD Data Access and Release webpage in the Informational Webinar section.
HPD Services Report
HCAI published the Healthcare Payments Data (HPD) Services Report. It consists of two interactive visualizations that allow users to explore the types of healthcare services provided to Californians each year, from 2018 to 2023. “Services” refers to individual healthcare procedures, which encompass everything from consultations with specialists to routine mammograms and anesthesia administration during surgery. Metrics reported include the total number of services, unique member counts, and service rates per 1,000 members.
Program Regulations
HCAI has prepared the following regulations packages for the HPD Program.
- HPD Program Non-Claims Payment Data Collection Regulations. Non-claims payments (NCP) are identified as information that submitters must provide to HPD as described in Health and Safety Code section 127673. HCAI submitted the NCP Data Collection Regulations to the Office of Administrative Law for final review on February 10, 2025, and got approval on March 25, 2025. Please refer to the HCAI Laws & Regulations website to review the approved regulations.
HPD Dental Plan Data Collection
Dental plans and submitters must be registered with the HPD Program through the Onpoint Health Data Claims Data Manager (CDM) prior to submitting data. Monthly data collection for dental file data is in full swing. Below is a recap of important dental file data collection due dates:
- Historical dental data files for the period from June 29, 2017, through December 2021 were due on October 31, 2024.
- Dental plans will begin regular monthly data file reporting for the month of November 2024 which were due on January 2, 2025. The HPD Reporting Manual Version 2.1 includes the monthly production submission schedule.
- Remaining historical dental data files for the period from January 2022, through October 2024 were due on February 3, 2025.
Please refer to California Code of Regulations Sections 97340, 97351, and 97352 for more information about these requirements or contact the HPD program at hpd@hcai.ca.gov for assistance.
NCP File Registration Update
Submitter registration takes place each year after plan registration has been completed. The registration period for 2025 closed on February 28, 2025.
As part of the upcoming NCP data collection efforts, during the 2025 annual registration period, plans and submitters had the option to register for NCP file submission. The following NCP file types will be added to the annual registration process for 2025:
- Annual Payments
- Pharmacy Rebates
- Capitation Submissions
Plans and submitters will have another opportunity to update their registration for NCP file submission later in the year once NCP data collection regulations are adopted.
Information regarding the proposed regulations for NCP data file collection can be found on the HCAI Laws & Regulations webpage under the Non Claims Payment Data Collection section.
Please reach out to hpd@hcai.ca.gov if you have any questions regarding NCP data collection. If you need assistance with the updated registration form, please contact hpd-support@onpointhealthdata.org.
National Association of Health Data Organizations (NAHDO) and the APCD Council Releases All-Payer Claims Database Common Data Layout (APCD-CDL™) v. 4.0.1
NAHDO and the APCD Council released the APCD-CDLTM version 4.0.1 on February 24, 2025 on the APCD Council website. The APCD-CDLTM version 3.0.1 will continue to be the file format used for HPD data collection through 2025. HCAI will work to update HPD data collection regulations before the end of 2025 and will provide instructions on the transition to APCD-CDLTM version 4.0.1 in early 2026.
HPD System Monthly Data File Submissions
HCAI greatly appreciates the efforts of all data submitters in their timely submissions and those that have adjusted their submission schedules to an earlier-in-the-month timeframe. Data submitters are encouraged to reach out to the HCAI team if there are any concerns with meeting the reporting deadline.
HCAI continues to conduct ongoing and regular evaluation of data quality and completeness to support both public reporting and the release of non-public data. HCAI is building annual plan reports and began meeting with plans to share the reports since May 2024. The reports include an executive summary, data visuals, and questions tailored to each plan and submitter. The annual plan reports will include a feedback loop for plans to share their experiences, provide an opportunity for plans to validate their data, inform HCAI about best practices across the commercial sector, and provide additional insight for public reporting of HPD data. HPD program staff will continue to reach out to plans on an ongoing basis to schedule a walk-through of these reports.
HPD Stakeholder Engagement
HPD Program Advisory Committee
The HPD Program Advisory Committee is comprised of health care stakeholders and experts to assist and advise the HCAI Director in formulating program policies about data collection, data management, data use, data access, and the development of public information to meet the goals of the HPD Program. The HPD Program Advisory Committee convenes quarterly.
Upcoming April Meeting
HCAI is hosting the next Advisory Committee meeting is on April 24, 2025, from 9:00 a.m. to 12:30 p.m. The April meeting will be held in a hybrid format where committee members and members of the public can attend in person at HCAI’s new Sacramento office – the May Lee State Office Complex (MLSOC) – or online via Microsoft Teams. Anticipated meeting topics include updates on data collection and release, including the status of applications received, as well as a year in review covering major milestones, the data request process, and key insights. The meeting is also anticipated to include an early experience discussion to cover insights on the application process and funding, researcher engagement, and coordination with sibling departments. Additionally, the meeting will include plans for 2025 with a focus on improving internal processes, supporting applicants, and expanding public outreach. The agenda and all other meeting materials will be posted on the HPD Program Advisory Committee webpage prior to the meeting.
Past Meetings
HCAI hosted a meeting on January 23, 2025, which focused on program strategy, the creation of a provider organization index and use cases for benefit design data. Previous Advisory Committee meeting materials are available on the webpage under the Meetings Archive section.
HPD Data Release Committee
The HPD Data Release Committee (DRC) is integral in supporting the implementation and administration of the HPD Program and advises HCAI on the release of HPD data. The HPD DRC convenes monthly unless otherwise stated. Below is information on the most recent and upcoming meetings.
Upcoming Meeting
The March 19, 2025, meeting has been canceled. HCAI is planning to host the next HPD DRC meeting on April 16, 2025, from 1:00 p.m. to 4:00 p.m. The meeting will be held in a hybrid format where committee members attend in person in Sacramento at the May Lee State Office Complex or HCAI’s Los Angeles offices. Members of the public can join either in person or online via Microsoft Teams. One meeting topic will be a review of the initial data use requests requiring the DRC’s recommendation for approval. The agenda and all other meeting materials will be posted on the HPD DRC webpage before the meeting.
Past Meetings
During the November 20, 2024, meeting, the DRC heard from representatives for the Connecticut and Arkansas All-Payer Claims Databases (APCDs) and discussed federal healthcare price transparency requirements. Previous DRC meeting materials are available on the HPD DRC webpage under the Meetings Archive section.
HPD Submitter Group
The HPD Data Program Submitters webpage provides a forum for submitters to receive the latest information on submission requirements, troubleshoot data submissions, and address other technical issues related to data submission. In addition, meetings are held to support entities required to submit or are supporting the submission of data to the HPD System. The HPD Submitter Group Meeting convenes quarterly.
Upcoming April Meeting
The HPD Submitter Group Meeting will happen April 10, 2025. Please register to attend the virtual meeting. Anticipated meeting topics include introducing new staff, key program updates, and a report on annual data quality. The agenda and all other meeting materials will be posted on the HPD Data Program Submitters webpage in the Submitter Group section prior to the meeting.
Past Meetings
The first meeting of 2025 for the HPD Data Program Submitter Group was held on January 9th. The meeting focused on welcoming a new team member, the status of production file submissions, both medical and dental, and a training by Onpoint on annual plan and submitter registration. Presentation materials are available on the HPD Submitter Group webpage.
HPD Data Program Submitter Resources
The HPD Data Program Submitters webpage offers submitter training materials under the Submitter Resources section. The training materials are provided by Onpoint Health Data to help HPD Data Program Submitters with registering and submitting files through the CDM. The Frequently Asked Questions section also provides information on registration and data submission. Please contact Onpoint Health Data at hpd-support@onpointhealthdata.org to view the training videos.
About the HPD Program
Assembly Bill 80 (Chapter 12, Statutes of 2020) provides HCAI the authority to establish the HPD Program. The HPD System is California’s All-Payer Claims Database, or APCD, and is intended to support greater health care cost transparency, inform policy decisions supporting quality health care, and reduce health care costs and disparities.
Watch the video below to learn more about the HPD Program. Also visit HCAI’s HPD Program webpage or email hpd@hcai.ca.gov for any questions. Subscribe to “Healthcare Payments Database News” to receive future newsletters if this newsletter was forwarded to you.
How does the HPD Collect and Report Data?
Find out by watching the video below.
HPD Program Careers
Are you interested in joining the HCAI Team? Click below to watch for job opportunities coming soon to support the HPD Program:
