The Department of Health Care Access and Information (HCAI) September HPD Program Quarterly Newsletter is designed to keep stakeholders informed on programmatic updates and ongoing stakeholder engagement.
HPD Program Updates
Public Reporting
HCAI released the Healthcare Payments Data (HPD): Fee-For-Service Drug Costs in the Commercial Market Report, which presents information about prescription drug spending and out-of-pocket costs. The visualizations cover three drug cost categories for 2021: the Top 25 costliest drugs in terms of total annual statewide spending, the Top 25 most frequently prescribed drugs, and the Top 25 drugs with the largest monthly median out-of-pocket cost (i.e., the median amount paid by the consumer for a month’s supply). Each visualization displays the total number of prescriptions statewide, the number of unique individuals with at least one prescription, the total statewide spending, the cost per prescription and the median monthly out-of-pocket cost across all prescriptions.
On August 29, HCAI conducted an “Ask the Analyst” webinar event, to allow the public to learn and ask questions about the HPD Prescription Drug Cost Report. The questions submitted and answers discussed in the webinar event are available in this summary fact sheet.
HCAI also updated the HPD Snapshot. This latest version of the Snapshot now includes 2021 Medicare fee-for-service data, which could not be included in the June 2023 Snapshot. Medicare fee-for-service data is collected according to the Centers for Medicare & Medicaid Services (CMS) data release schedule, which can result in a lag in data availability. Additionally, some data submitters were not able to submit data in time for inclusion in the June 2023 Snapshot. For the 2024 Snapshot, all mandatory submitters’ data was received for the reporting period and is included. The HPD Snapshot is an overview of data currently available as submitted in the HPD System with visualizations that allow users to explore how many Californians received coverage from each type of insurer and the number of medical or pharmacy service records generated. Two of the visualizations highlight the 25 most frequently reported medical procedures and the 25 most reported drug prescriptions dispensed, with filters to view the frequency of specific procedure categories or prescription drug classes.
The October HPD Advisory Committee meeting will be focused on public reporting priorities.
Program Regulations
HCAI has been preparing the following regulations packages for the HPD Program.
- HPD Program Data Release Regulations. On July 17, 2024, HCAI received a Decision of Disapproval from the Office of Administrative Law (OAL) for the HPD Data Use, Access, and Release regulations. HCAI has worked with OAL to revise the regulations, which were posted for a new public comment period on September 6, 2024. The comment period closes September 23, 2024. Please refer to the HCAI Laws & Regulations website to review all rulemaking documents.
- HPD Program Non-Claims Payment Data Collection Regulations. Non-claims payments are identified as information that submitters must provide to HPD as described in Health and Safety Code section 127673. HCAI released the non-claims payment regulations to public comment on August 2, 2024, with the standard 45-day comment period closing on September 17, 2024. HCAI anticipates regulation implementation in early 2025. The Non-Claims Payment Data Fact Sheet, updated April 19, 2024, provides additional information on non-claims payment data collection efforts, including a timeline of the regulation development process and a frequently asked questions section for health plans and submitters. Please refer to the HCAI Laws & Regulations website to review all rulemaking documents.
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). Below are important upcoming dates for dental plans and submitters to be aware of regarding dental data collection:
- Historical dental data files for the period from June 29, 2017 through December 2021 must be submitted by October 31, 2024.
- All remaining dental data for the period beginning January 2022 through October 2024 must be submitted by February 1, 2025.
- Dental plans will follow the Monthly Production Submission Schedule and submit November 2024 data by January 1, 2025.
Please refer to California Code of Regulations Sections 97340, 97351, and 97352 for more information about these requirements.
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 in 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 through the end of the year to schedule a walk-through of these reports.
HPD Stakeholder Engagement
Voluntary Self-Funded Outreach
Voluntary submission of data from self-funded entities was a topic of discussion at the July 25, 2024 Advisory Committee meeting. ERISA self-funded data submitted to HCAI represents a significant gap in the database, with approximately 300,000 lives (about 7%) of the 4.5 million estimated total to be in the HPD for 2022 calendar year. The first phase of efforts to increase submission of self-funded data featured informational interviews with other APCDs and with purchasers and health plans providing Administrative Services Only (ASO) products. In response, HPD developed resources for voluntary submitters. The next phase of engagement efforts will focus on follow-up discussions with ASO plans, outreach to large employers and Taft Hartley plans, and exploring partnering with additional stakeholders such as benefits consultants.
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 October Meeting
HCAI is hosting the next HPD Program Advisory Committee meeting on October 24, 2024, from 9:00 a.m. to 12:30 p.m. The October 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. Meeting topics include program updates on data collection including NCP regulations and NAHDO updates and a prescription drug visualization walkthrough. 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 July 25, 2024, which focused on data collection activities, including non-claims data collection and voluntary data collection. 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 November Meeting
HCAI is hosting the next HPD DRC meeting on November 20, 2024, 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 at the Sacramento or Los Angeles offices, while members of the public can join in person or online via Microsoft Teams. Meeting topics includes a continuation discussion of potential use case scenarios for data requests that may appear before the committee. The agenda and all other meeting materials will be posted on the HPD DRC webpage prior to the meeting.
Past Meetings
During the meeting on June 19, 2024, the DRC reviewed resources created to assist the DRC in conducting reviews or data requests and continued the use case discussion started at the March meeting. Previous DRC meeting materials are available on the HPD DRC webpage under the “Meetings Archive” section.
HPD Submitter Group
The HPD Program Submitter Group provides a forum for HPD Data Submitters to receive the latest information on submission requirements, troubleshoot data submissions, and address other technical issues related to data submission. These meetings are intended for entities required to submit or are supporting the submission of data to the HPD System. The HPD Submitter Group convenes quarterly.
Upcoming October Meeting
The next HPD Submitter Group meeting of 2024 will be held on October 10th. Please register to attend the virtual meeting. Anticipated meeting topics include introducing new staff, key program updates, the status of production file submissions, a review of data quality assurance and improvement, and a review of the pharmacy cost dashboard and the snapshot and measures dashboard. The agenda and all other meeting materials will be posted on the HPD Program Submitters Group webpage prior to the meeting.
Past Meetings
The most recent HPD Program Submitter Group meeting was held on July 11, 2024, and focused on the status of production file submissions, a review of data quality assurance and improvement, an update to non-claims payments, and a presentation by Onpoint Health Data about dental data submission. Presentation materials are available on the HPD Submitter Group webpage.
HPD Program Submitter Resources
The HPD Program Submitters webpage offers submitter training materials under the Submitter Resources Section. The training materials are provided by Onpoint Health Data to help HPD 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:
