Data request

Overview

CT All-Payer Claims Database Data Release Process

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

***HUSKY A - children, teens, parent, pregnant women, & relative caregivers. HUSKY B or Children's health insurance program (CHIP) for children and teens up to age 19. HUSKY C for adults 65 and older, and adults with disabilities. HUSKY D for low-income adults without dependent children.

Payer Population Claim type Years available from Years available to
Commercial**

Fully Insured (individual, small and large group plans)

Eligibility/Enrollment: Medical and pharmacy claims

1/1/2012

6/30/2024

Commercial**

Self-insured (individual, small and large group plans) including State Employees/Retirees Plan & Municipalities in State Partnership Plan, and some employer sponsored plans

Eligibility/Enrollment: Medical and pharmacy claims

1/1/2012

6/30/2024

Medicaid (HUSKY Health)

All ages***

Eligibility/Enrollment: Medical and pharmacy claims

1/1/2015

6/30/2024

Medicare (fee for service)

Ages 65 and older, and under age 65 with certain disabilities/conditions

Eligibility/Enrollment: Pharmacy claims

1/1/2012

12/31/2019

Medicare (Part D)

Drug Plan (Fee for service/Medicare Advantage)

Pharmacy claims

1/1/2012

12/31/2018

Medicare (Medicare Advantage)

Health plans provided by a private companies contracted by Medicare. Most plans include Part D.

Eligibility/Enrollment: Medical and pharmacy claims

1/1/2012

6/30/2024

*Denied and Dental claims and new REL data collection began January 2024 

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:

Final expenses must be paid before the data request is fulfilled. Please see below for the data fee schedule:
 
Commercial Non-profit/educational State agencies Assessed
Types of files Initial extract Additional extract Initial extract Additional extract Initial extract Additional extract Initial extract Additional extract
Inpatient facility

$3,000

$1,500

$1,000

$500

$750

$375

$2,500

$1,250

ER facility

$3,000

$1,500

$1,000

$500

$750

$375

$2,500

$1,250

Outpatient facility

$3,000

$1,500

$1,000

$500

$750

$375

$2,500

$1,250

Professional claims

$6,000

$3,000

$2,000

$1,000

$1,500

$750

$5,000

$2,500

All Medical claims

$12,000

$6,000

$4,000

$2,000

$3,000

$1,500

$10,000

$5,000

Pharmacy claims

$3,000

$1,500

$1,000

$500

$750

$375

$2,500

$1,250

Member eligibility

$5,000

$2,500

$1,650

$825

$1,250

$625

$4,170

$2,085

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. CT APCD Data Request Form

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Dictionary

An APCD data dictionary is available in both Excel and PDF files here:

Application

Office of Health Strategy APCD requires data requestors to complete the following application to request access to data: