The Department of Health Care Access and Information (HCAI) March Health Care Payments Data (HPD) Quarterly Newsletter is designed to keep stakeholders informed on programmatic updates including information about the upcoming Advisory Committee and Submitter Group Meetings, relevant federal updates impacting All Payer Claims Databases (APCD), and HPD careers.
HPD Programmatic Updates
HPD Funding Report:
In 2018, the Legislature provided $60 million in one-time funding to establish the HPD Program. The HPD statute requires HCAI to submit a report to the Legislature on recommendations for long-term funding options for the program. On February 28, 2023, HCAI submitted the required report to the Legislature, outlining the HPD Program’s accomplishments to-date, a plan for future spending, and recommendations on long-term program funding options. Read the full report here: Long Term Funding Options for the HPD Program
Save the date for HPD’s Submitter Group Meeting:
The second quarter of 2023 HPD Submitter Group meeting will be held on April 13, 2023. Please use this link to register for the HPD Submitter Group to have the meeting added to your calendar. The agenda and instructions to register will be posted to the HPD Program Submitters website.
January Submitter Group Review:
The first meeting of the year was held January 12, 2023, with the focus on production file submission status, annual registration, variance processes, and monthly data submission frequently asked questions. Please contact email@example.com at any time there are questions. We are happy to help!
Future Dental Plan Submitter Group Poll:
Per California Code of Regulations Sections 97330, 97350, 97351, and 97352, HCAI is preparing to collect dental plan data in 2024. This will include plan and submitter registration for dental plans who currently do not submit to HPD, a period to test dental data submission, and a timeline for historical and current year dental data submission. In the summer of 2023, HCAI will begin outreach activities to anticipated mandatory dental plan submitters. Please respond to the following poll so we will be sure to include all the dental plans in our introductory outreach meeting. Please complete this poll below if your organization is responsible for dental plan coverage in California. We will keep this poll open until April 13, 2023.
Dental Plan Coverage Survey
Annual Plan and Submitter Registration:
The annual submitter registration for the 2023 calendar year has concluded. Thank you to health plans and insurers for sending in your information for this annual process. If your organization has not completed registration, please contact firstname.lastname@example.org for instructions. Please see California Code of Regulations Section 97334 for more information regarding registration information update.
It is recommended that plans and insurers review their membership on an annual basis to determine if they are subject to the requirements of the HPD program. Plans and insurers with membership at or above 40,000 covered lives are mandatory submitters and are required to submit data to HPD. Health and dental plans with membership below 40,000 covered lives may participate in HPD as voluntary submitters. Please see California Code of Regulations section 97310 for more information regarding plan size threshold.
Monthly Data File Reporting and Submissions:
The HPD program is now processing ongoing monthly data file submissions from health plans and insurers. Please refer to page 12 of the HPD Reporting Manual for an outline of the reporting period and corresponding submission due dates. Regulatory provisions regarding ongoing monthly data submission are cited in California Code of Regulations Sections 97340 and 97352. Please contact the HPD program at email@example.com regarding questions or concerns with meeting this regulatory requirement.
HPD System Data Collection:
The HPD System has collected and processed over 16 billion total records of production data from CMS, the Department of Health Care Services, and commercial data submitters! HCAI greatly appreciates the efforts of all data submitters, including those already submitting 2022 data to the System. HCAI will be conducting ongoing and regular evaluation of data quality and completeness to support both public reporting and the release of non-public data. HCAI will submit a report to the Legislature on the quality and completeness of the database by March 1, 2024, which will include an assessment of the data that has been submitted and the percentage of the California population that is represented in the database.
HPD Public Reporting :
The HPD program is preparing to release its first public reports in July 2023. These initial public reports are expected to include submitters who completed data submission by February 3, 2023 and will include reporting periods of 2017-2021. HCAI received input on first-year public reporting from the HPD Advisory Committee at the October meeting, and from the HPD Data Release Committee at the January meeting. 2023 public reports will include a snapshot of the data collected by the HPD program; an interactive visualization focused on Californians’ chronic conditions, health care utilization, and demographics; and a report on pharmaceutical costs. These committees emphasized the importance of describing the methods used to produce these reports and providing other information that will help users understand the relationship between these reports and data from other sources. Committee members also made suggestions for more granular reporting in several areas and recommended additional metrics to be included in these and future reports.
Data Release Regulations and Certification of HPD Data Collection Emergency Regulations:
HCAI is preparing for two regulation packages for the HPD program. The first is for the HPD data release program. The second is to certify HPD’s emergency regulations for data
collection which took effect on December 20, 2021. Both regulation packages will be noticed for public comment in the coming months.
Participation in National Workgroups:
HCAI and the HPD Program continue to participate in the APCD Council’s All-Payer Claims Database Common Data Layout (APCD-CDL™) Data Maintenance Request (DMR) workgroup. The APCD-CDL™ version 3.0 was released on January 13, 2023 and is available for request at the APCD Council website. The APCD-CDL™ version 2.1 will continue to be the file format used for HPD’s data collection through 2023. HCAI will update HPD regulations to include the use of APCD-CDLTM version 3.0 and instructions on the transition in late December 2023. HCAI and the HPD Program also continue to participate in the Non-Claims-Based Payments workgroup, to develop a national standard for collecting non-claims-based data.
HPD Advisory Committee
Pursuant Chapter 8.5 of Part 2 of Division 107 of the Health and Safety Code (HSC), §127671 et seq. HCAI is required to convene a California Health Care Payments Data (HPD) Program Advisory Committee comprised of health care stakeholders and experts to assist and advise the HCAI Director in formulating program policies regarding data collection, management, use, access, and development of public information to meet the goals of the HPD Program.
HCAI hosted the January Advisory Committee on January 26, 2023. The meeting was focused on the approach to collecting Non-Claims Data, including a review of how other states approach Non-Claims Data collection and what HCAI’s proposed approach is to collect these data for the HPD System.
Meeting materials can be found here.
HCAI is hosting the upcoming HPD Advisory Committee Meeting on April 27, 2023. The meeting will be held from 9:00 a.m. to 12:30 p.m. (PST). The April HPD Meeting will be held in a hybrid format allowing members of the public and committee members to attend in person or via Microsoft Teams.
The April meeting will focus on HPD’s data access and release program and policy topics, and an update on the first few HPD Data Release Committee meetings.
The agenda and all other meeting materials will be posted on the HPD Advisory Committee website prior to the meeting.
HPD Data Release Committee
Pursuant to Health and Safety Code Section 127671, et seq, HCAI is required to convene a Data Release Committee (DRC) to support the implementation and administration of the Health Care Payments Data (HPD) Program. The DRC is an integral part of the HPD Program, advising HCAI on the release of HPD data.
HCAI hosted a DRC meeting on January 10, 2023, which focused on an overview of the data elements submitted to HPD, the types of data sets that will be available to requestors, the draft data access and release regulations and a review of data access methods.
HCAI also hosted the second DRC meeting of 2023 on March 7, 2023. This meeting was focused on considerations for release of HPD data elements including personally identifiable information (PII), Entity and Financial Indicators (EFI) and data elements around sensitive conditions and vulnerable populations.
All past DRC meeting materials can be found here.
HCAI is hosting the next DRC Meeting on May 2, 2023, which will be focused on discussing the various roles and responsibilities during the data release process including the role of HCAI, the DRC as well as other non-HCAI reviewers such as the Committee for the Protection of Human Subjects and the Department of Health Care Services. This meeting will also cover the role of the DRC in serving as a public forum for data release activities.
This meeting will be fully virtual via Microsoft Teams.
The agenda and all other meeting materials will be posted on the HPD Data Release Committee website prior to the meeting.
Are you interested in joining the HPD Team?
Visit the HCAI Careers page for job opportunities coming soon to support the HPD Program.
Watch the HPD Program’s Video
About the HPD Program
Assembly Bill 80 (Chapter 12, Statutes of 2020) provides HCAI the authority to establish the Health Care Payments Data Program (HPD), often referred to as an All Payer Claims Database or APCD, which is intended to support greater health care cost transparency, inform policy decisions supporting quality health care, and to reduce health care costs and disparities.
To find out more please visit HCAI’s HPD Webpage or email firstname.lastname@example.org. If this newsletter was forwarded to you, and you would like to receive future ones please subscribe to “Healthcare Payments Database News” here.