Healthcare Payments Data (HPD) Program Quarterly Newsletter September 2025

Program Updates#

Public Reporting#

HCAI produces various data products and analytic reports using HPD data to support the goals of the program. HCAI anticipates continuing to advance the accessibility and usefulness of HPD public reports as the database becomes more comprehensive and HCAI builds its capacity over time. Below are the public reports HCAI has published to date. Visit HPD Public Reporting for more information.

• The HPD Snapshot provides a wealth of information about what data is available in the HPD, with visualizations that allow users to explore how many Californians received coverage from each payer type and the number of medical or pharmacy service records generated. The HPD Snapshot was updated in July 2025 to include service data through December 2023.
• The HPD Measures Report features a series of interactive visualizations that explore health conditions, healthcare utilization, and patient demographics for Californian consumers. An update to the HPD Measures Report was released in August 2025. This update includes data through December 2023 and a new map allowing data to be viewed separately for each of Los Angeles County’s eight Service Planning Areas (SPAs).
• The HPD Prescription Drug Cost Report is the first report on healthcare costs from the HPD and presents the top 25 costliest, most prescribed, and highest out-of-pocket fee-for-service paid drugs in the commercial market in 2021.
• The HPD Services Report consists of two dashboards that allow users to explore the types of healthcare services, ranging from a consultation with a specialist to a routine mammogram to anesthesia administration during surgery, provided to Californians each year, from 2018 through 2023.
• The Medical Out-of-Pocket Costs and Chronic Conditions Report explores the financial responsibility of California consumers for their medical care in 2022. It focuses on cost-sharing out-of-pocket expenses (i.e., the costs of covered medical services that are not reimbursed by insurance but are instead paid by consumers). These can be examined separately for 23 specific chronic conditions and compared between Californians without chronic conditions, those with one condition, and those managing multiple conditions.
• The Data Debrief: Avoidable Emergency Department Visits Vary Widely Across California examines potentially avoidable emergency department visits across payer types and geographic areas of California using 2023 data from HPD.
• The Data Brief: Payment Arrangements in California’s Commercial and Medicare Advantage Markets in 2023 provides a picture of payment arrangements currently in use in California’s commercial and Medicare Advantage markets for three categories of services: inpatient facility, outpatient facility, and professional.

Data Access and Release#

The Data Release Program was launched in December 2024 to allow 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.

HCAI has published an HPD Data Completeness Fact Sheet to assist prospective data requestors assess whether the HPD is suitable to use for their particular research project.

Visit HPD Data Access and Release and HCAI Data Resources for more information.

Program Regulations#

Notice of 45-Day Public Comment Period

On September 12, 2025, proposed updates to the HPD Data Collection regulations were published in the California Regulatory Notice Register and are now available for public comment. The last day to submit comments is October 30, 2025. This proposed rulemaking seeks to update and clarify specific regulation sections and update documents incorporated by reference to ensure the HPD Data Collection regulations are maintained and updated regularly and the HPD contains the most accurate and comprehensive data. HCAI anticipates regulation adoption in early 2026. Associated documents are linked below.

• Notice of Proposed Rulemaking
• Text of Proposed Regulations
• Initial Statement of Reasons
• HPD Data Submission Guide, Version 4 – Amended
• HPD Data Submission Guide, Version 4 – Final
• All-Payer Claims Database Common Data Layout (APCD-CDL^TM) Version 4.0.1 (released February 2025)

The National Association of Health Data Organizations (NAHDO) and the All-Payer Claims Database (APCD) Council released the APCD-CDL^TM version 4.0.1 on February 24, 2025, on the APCD Council website. The APCD-CDL^TM version 3.0.1 and the NCP Data Layout^TM version 1.0 will continue to be the file format used for HPD data collection through 2025.

Visit the HCAI Laws & Regulations to review all program regulations.

Non-Claims Payment (NCP) Data Collection Key Dates#

Registration reopened for plans on April 1, 2025, and for submitters on May 1, 2025, in order to confirm NCP file submission to the HPD program. Registration must be completed prior to submitting NCP test or production ready files. NCP submissions include the Annual Payments, Pharmacy Rebates, and Capitation files. Below are key dates for submitting production NCP data files:

• By September 1, 2025, plans and submitters will begin testing for NCP files, to be completed by June 30, 2026.
• 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 files.

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 to 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 2027. Read the Pharmacy Benefit Manager Fact Sheet for more information.

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 on October 23, 2025, 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. Anticipated topics include updates on data collection, data release, and public reporting priorities and progress. 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 supporting the implementation and administration of the HPD Program and advises HCAI on the release of HPD data. Unless otherwise stated, the HPD DRC convenes monthly, and stakeholders will be notified of cancellations at least two weeks prior to the meeting date.

The next HPD DRC meeting will be on January 21, 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. 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 October 9, 2025. Register to attend the virtual meeting. Anticipated meeting topics include key program updates, a report on data quality reports, NCP submission status and resources, and Onpoint Health Data will present on NCP testing feedback and APCD-CDL v4.0.1 transition overview. 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 watch for job opportunities coming soon to support the HPD Program: