CT All-Payer Claims Database Data Release Process
Overview
CT’s All-Payers Claims Database (APCD) contains over one billion records that include medical claims, pharmacy claims, eligibility, and provider files from commercial, Medicare, and Medicaid payers. The sources and types of claims data and years available are as follows:
**Anthem, Aetna, Cigna East, Cigna West, ConnectiCare, United Healthcare, HealthyCT, Harvard Pilgrim, Optum Health, Oxford, WellCare Health, eviCORE Healthcare, Express Scripts, Caremark Reporting threshold – 3,000 members
Currently, OHS releases data extracts “to any state agency, insurer, employer, health care provider, consumer of health care services, researcher, or the Connecticut Health Insurance Exchange for the purpose of allowing such person or entity to review such data as it relates to health care utilization, costs or quality of health care services. Such disclosure shall be made in a manner to protect the confidentiality of health information, as defined in 45 CFR 160.103, and other information, as required by state and federal law.”[1] For entities outside the State of CT government, OHS releases a de-identified data extract containing commercial non-Medicare Advantage data only.
There is a seven step process applicants follow to receive APCD data which begins with the initial request.
1. Initial Request
Prior to submitting a data request to the Connecticut Office of Health Strategy (OHS), please review all documents including APCD privacy policies and procedures and the APCD Data Dictionary for data tables and elements/fields. After reviewing the documentation, please contact OHS.APCD@ct.gov to setup an informational session. Topics for the informational meeting include:
- Understanding OHS data privacy and security requirements
- Identifying the best ways to tailor data requests to make best use of Connecticut’s APCD
- Understanding the application review process
- Calculating pricing based on your requested scope of work OHS staff will also provide an estimate of your project cost if it involves additional analytics involved in either customized data preparation or developing reports.
2. Submission
- Submit your data request application through the OHS GovQA website: https://ohsct.govqa.us/WEBAPP/_rs
- Once your application is submitted, OHS staff will reach out to receive the non-refundable $50 application fee, electronically:
3. Administrative Review
- Objective and methodology of the research;
- Requestor’s data and computation infrastructure;
- Cost of application.
4. Committee Review and Approval
The APCD Data Release Committee (DRC) reviews all requests for compliance with state and federal privacy laws, including HIPAA required mandate that the data sought is the minimum amount necessary to achieve a specific public purpose and establishing that the Data Dictionary is adequate. The Data Release Committee is a group of experts representing carriers, providers, researchers, state agencies, providers, and consumers.
5. Execute a Data Use Agreement
Once the application is approved by the Connecticut Office of Health Strategy and the Data Release Committee, you will be required to execute a Data Use Agreement. Agreements must be signed prior to release of data extract.
6. Submit Payments
Final expenses must be paid before the data request is fulfilled. Please see below for the data fee schedule:
Fees may include cost for analytic services if any analytics or aggregation is requested.
7. Data Request Fulfillment
Once the Data Use Agreement is signed by both you and OHS’ Executive Director, and OHS receives your full payment, OHS processes your data request and sends you the completed data or analysis.
Application
Office of Health Strategy All-Payer Claims Database (”APCD”) requires data requestors to complete the following application to request access to APCD data:
Dictionary
An APCD data dictionary is available in both Excel and PDF files here: