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About

Rhode Island Numbers

Information for

Programs

Publications

Regulations

Partners

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.

Mission

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 will include

The Rhode Island All Payer Claims Database (RI-APCD), will be a repository of healthcare insurance payment information for people living in Rhode Island. The data will come 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 will be "de-identified", meaning that names, address, and other personal information will be removed so that information in the database cannot be linked to particular people. All information collected will be anonymous and security will be very tight. In addition, all Rhode Island residents whose information would otherwise be collected will 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 future, researchers may also be able to request data, with restrictions.

The RI-APCD will include data on medical claims, pharmacy claims, healthcare providers and member enrollment. Historical data will include data from 2010 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.

Timeframe

The data gathering process will begin in January 2014, with data submission scheduled to begin in May 2014. The plan as of January 2014 calls for the release of a Request for Proposals for Analytics March-April of 2014.