Health Care Payments, Media Center

Healthcare Payments Data (HPD) Program Quarterly Newsletter June 2026

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Program Updates

Public Reporting

HCAI produces various data products and analytic reports using HPD data to support the goals of the program. Most recently, HCAI released the Healthcare Payments Data (HPD) Inpatient Stay and Outpatient Visits Report. This interactive visualization provides three metrics for selected types of inpatient stays, outpatient diagnostic visits, outpatient surgical visits, and professional visits: the total number of visits (or stays), the visit rate per 1,000 members, and the median out-of-pocket (OOP) cost per visit by year (2018 – 2023). These metrics are broken down by county, and for Los Angeles County, by Service Planning Area (SPA).

HCAI recently also published two data briefs focused on specific pharmaceutical cost, access, and utilization topics that are relevant to Californians. The first – GLP-1 Prescriptions for Weight Loss over Time, 2018-2023 – examines trends in the prescription of five GLP-1 drugs for weight loss, compares total costs for GLP-1s between Medi-Cal and commercial payers for each drug, and maps the average total yearly cost per member by county. A key finding is that the number of GLP-1 prescriptions for weight loss in California was over 34 times greater in 2023 than in 2018.

Visual data showing GLP-1 prescriptions by year for Medi-Cal and commercial payers, 2018-2023.

A second data brief – Insulin and Metformin Geographic Access and Mail‑Order Use – highlights geographic patterns in average prescription pickup distance and mail-order reliance for insulin and oral medication metformin used to manage diabetes in 2022. The brief shows that in some California regions, residents face substantial travel distances without a corresponding increase in mail order use. Conversely, counties in the Bay Area and the Central Valley display shorter travel distances but higher mail order utilization, indicating that mail order may be supporting access where brick and mortar pharmacy options are limited.

Data Access and Release

The Data Release Program allows researchers, state agencies, and other qualified applicants to request access to non-public HPD data. To apply for HPD datasets, register for an account through HCAI’s Data Request Portal and follow instructions for submitting a detailed application, including a description of your research, data needs, and privacy measures.

As of June 9, 2026, there are 34 pending HPD data requests at various stages of review, including requests from universities, public agencies, research organizations, and other entities. During the same period, 16 requests have been completed (3 supplemental) and fulfilled, providing data access to organizations such as SEIU-UHW, RAND, and the California Hospital Association. Additionally, several requests have been withdrawn or closed, reflecting the dynamic nature of the application process. For more details and the latest updates, visit the List of Pending and Competed HPD Application Updates page on the HCAI website.

Non-Claims Payment (NCP) Data Collection Key Dates

NCP submissions include the Annual Payments, Pharmacy Rebates, and Capitation files. Below are key dates for submitting production NCP data files:

  • By June 30, 2026, plans and submitters are required to complete testing for NCP files.
  • Historical annual payment files and pharmacy rebate files for the period from June 29, 2017, through December 31, 2024, are due on July 31, 2026.
  • Capitation files for the period from June 29, 2017, through July 31, 2026, are due on September 1, 2026.
  • Initiation of ongoing annual payment and pharmacy rebate files will begin on    September 30, 2026, starting with calendar year 2025 files.
  • Initiation of ongoing monthly capitation files will begin on October 1, 2026, starting with August 2026 reporting month file.

Visit HPD Resources for more information.

Pharmacy Benefit Manager Data Collection

Pharmacy Benefit Managers (PBMs) are intermediaries between health plans, pharmacies, and pharmaceutical manufacturers and are responsible for administering prescription drug benefits on behalf of health plans. Their central role in the complex prescription drug market makes it difficult to understand the total cost of prescription drugs along the pharmaceutical supply chain.

The 2025 State Budget Health Omnibus Bill (Assembly Bill 116) requires HCAI to collect cost data from PBMs, adding to the data and information available in the HPD for use by policymakers, researchers, and the public about the prescription drug marketplace in California. HCAI intends to collect data from PBMs on drug pricing, fees paid for PBM services, and pharmacy rebates. PBM data collection is anticipated to begin in 2028. Read the Pharmacy Benefit Manager Fact Sheet for more information.

HCAI expects to begin regulations workshopping shortly. Below is the PBM data collection implementation timeline.

Graphic titled PBM Milestone Timeline that show quarterly levels by the years 2026, 2027 and 2028.

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.

The next Advisory Committee meeting will be held on July 23, 2026, from 9:00 a.m. to 12:30 p.m. The July meeting will be held in a hybrid format where committee members and members of the public can attend in person at the Sacramento office or online via Microsoft Teams. The meeting will focus on updates on HPD data collection, data quality and efforts and engagement, and data collection updates on dental, non-claims payment, and Pharmacy Benefit Managers data. The meeting will also include updates on provider data quality and use. The agenda and meeting materials will be posted on the HPD Program Advisory Committee webpage prior to the meeting. 

Visit the Advisory Committee Meetings Archive for past meeting materials.

HPD Data Release Committee

The HPD Data Release Committee (DRC) is integral to support the implementation and administration of the HPD Program and advises HCAI on the release of HPD data. The HPD DRC has monthly meetings scheduled, but they convene only when needed, such as when there are data requests that trigger a mandatory review. To date, no data requests triggering DRC review have reached that step in the process, though several are likely to in the coming months. Cancellations will be communicated to stakeholders at least two weeks before the scheduled date.

On May 20, 2026, HCAI convened the HPD DRC to review program updates, discuss lessons learned from early data request workflows, and prepare for the committee’s first formal application review. Members aligned improvements to reviewer assignments, documentation practices, and meeting cadence, and agreed to form an administrative subcommittee to support the HPD Data Release Committee between formal public meetings. 

The next HPD DRC meeting is scheduled for August 19, 2026, from 1:00 p.m. to 4:00 p.m. At this time, HCAI is thoroughly evaluating applications for completeness and alignment with all statutory, regulatory, and other requirements before referring requests to the DRC.

The meeting will be held in a hybrid format where committee members attend in person at HCAI’s offices in Sacramento or Los Angeles, as well as a location at the Inland Empire Health Plan. Members of the public can join either in person or online via Microsoft Teams. Meeting topics will include a review of 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.

Visit the DRC Meetings Archive for past meeting materials.

HPD Submitter Group

The HPD Submitter Group Meetings provide a forum for submitters to receive the latest information on submission requirements, troubleshoot data submissions, and address other technical issues related to data submission. 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.

The next HPD Submitter Group Meeting will be on July 9, 2026. Register to attend the virtual meeting. Anticipated meeting topics include key program updates, review of upcoming deadlines, NCP submission reminders, data quality review, and resource review. The agenda and meeting materials will be posted on the HPD Program Submitters webpage prior to the meeting.

Visit the HPD Submitter Group Meetings Archive for past meeting materials.

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 more information. 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 look at job opportunities coming soon to support the HPD Program:

         

Red, yellow and blue logo that says We are hiring, apply now, Join our HCAI Team