All-Payer Claims Data Base Project
The development Rhode Island All Payer Claims Database is a collaborative effort amongst the Rhode Island Department of Health, the Office of the Health Insurance Commissioner, the Health Benefits Exchanges, and the Executive Office of Health and Human Services.
To provide actionable data to support the study and comparison of healthcare utilization, cost, and trends; to identify opportunities for improvement in healthcare quality in Rhode Island; and, to inform consumers
What the Database includes
The Rhode Island All Payer Claims Database (RI-APCD), is a repository of healthcare insurance payment information for people living in Rhode Island. The data comes from the major health insurance companies doing business in Rhode Island, including fully-insured and self-funded commercial plans, Medicare and Medicaid.
The RI-APCD is one of many All Payer Claims Databases being implemented in the country. more The data in the RI-APCD is "de-identified", meaning that names, address, and other personal information is removed so that information in the database cannot be linked to particular people. All information collected is anonymous and security is very tight. In addition, all Rhode Island residents whose information would otherwise be collected have the opportunity to opt-out of the database at any time. Aggregate, de-identified data will be made available to the general public. In the spring of 2015, researchers will also be able to request data, with restrictions.
The RI-APCD includes data on medical claims, pharmacy claims, healthcare providers and member enrollment. Historical data includes data from 2011 through 2013. The database will not include data for uninsured individuals, uninsured individual obtaining services at a Federally Qualified Health Center; any healthcare service paid directly by an individual; and uncompensated (free) care. Dental claims and claims for insurers with a relatively small share of the market will also be excluded.
The data gathering process began in January 2014, with data submissions from insurance carriers on an ongoing basis. Public reporting products will start to be available in early 2015.