All-Payer Claims Database

Acronym: APCD

Is a database of claims and related data that has been submitted by payers or providers, depending on the APCD arrangement. State requirements dictate if the data is exchanged as identifiable or de-identified. No separate arrangements are required between the providers and payers and APCD for the submission of the data. Payment made to the provider for services may be fee-for-service or an alternative payment model and is unrelated to the process of transmitting the claims data to the APCD. At this time, APCDs are state-based and not every state has one. Each states’ legislation and regulation defines the scope and limitations of the APCD, including whether reporting is mandatory or voluntary, the data reported, the transmission methods, who has access to the data, etc. APCDs use the data received to analyze health care services to better understand utilization, costs, quality of care, and other aspects of care delivery.