What is the All-Payer Claims Database?
The Connecticut All-Payer Claims Database (APCD) is a secure, statewide data system managed by the Office of Health Strategy (OHS). It collects medical, pharmacy, and dental claims and provider data from commercial health insurers, Medicaid, and Medicare. The APCD helps policymakers, researchers, and the public understand healthcare cost, quality, and utilization trends to support data-driven decisions.
How comprehensive is the APCD?
The APCD currently contains over 2.2 billion claims representing approximately 86% of insured Connecticut residents. This includes fully and self insured commercial coverage, Medicaid, and Medicare. While some self-insured employer plans are not required to report under federal law, many participate voluntarily. OHS works with employers and carriers to expand participation and ensure broad representation of Connecticut’s healthcare system and provides an easy to use form self-insured employers can use to opt-in to APCD data submission.
Why don’t all self-insured employer plans report data?
Under the U.S. Supreme Court’s Gobeille v. Liberty Mutual 2016 decision, States cannot compel self-insured (ERISA) plans to submit data. Connecticut encourages voluntary participation, and many self-insured plans—including the State of Connecticut employee plan—already contribute data. Although full ERISA participation would improve completeness, research suggests that existing data reliably reflects overall healthcare trends.
How is the data used?
The APCD is a cornerstone of OHS’s analytic and regulatory work, supporting:
- Healthcare cost growth benchmark and affordability analyses
- Certificate of Need (CON) reviews
- Cost and quality transparency dashboards
- Legislative and policy reports
- Health equity and access analyses
- Research collaborations with academic and nonprofit partners
OHS also supports other health and human CT state agencies and external users, including researchers, payers, and providers, through a structured data release process that protects privacy and promotes responsible data use.
How does the APCD protect patient privacy?
All APCD data are de-identified in accordance with the Health Insurance Portability and Privacy Act. The Office of Health Strategy (OHS) and the APCD Data Release Committee conduct strict reviews of all data release requests. Applicants must demonstrate a clear public purpose, robust privacy and security protections, and agreement to data use restrictions. Only aggregated or masked information is published.
Is the APCD easy to use?
The APCD is a highly technical database designed primarily for research, policy, and analytics. Some users may find the data complex to navigate. To support access and usability, OHS provides:
- Detailed data documentation and metadata
- Standardized data request templates and guidance
- Tiered data products (summary dashboards, public datasets, and research-level files)
- Dedicated technical assistance and helpdesk support
OHS invests in continuous improvements, within available appropriations, to simplify the user experience and enhance transparency.
What kinds of public tools or dashboards are available?
OHS develops interactive dashboards that present cost, utilization, and quality information derived from the APCD. These dashboards provide high-level, comparative insights across payers, providers and regions. The HealthscoreCT website, managed by OHS, features some of the interactive dashboards APCD data supports. APCD data also helps support data transparency in statutorily defined programs, including the Healthcare Benchmark Initiative.
Dashboards reflect aggregated averages, and are not intended to predict individual medical costs or benefits. Users are encouraged to consult their health plan for personal cost estimates.
How does OHS ensure transparency and accountability in APCD operations?
OHS publishes key documentation on APCD governance, data policies, and major contracts. All data releases, vendor procurements, and contract renewals comply with state procurement policies. OHS also engages stakeholders in the governance process by convening advisory bodies, including the APCD Advisory Group and Data Release Committee and the Health Information Technology Advisory Council (HITAC), to facilitate community input and oversight.
What are OHS’s current priorities for the APCD?
OHS defines priorities for the APCD in collaboration with advisory bodies, the administration, the legislature and other stakeholders focusing, within available appropriations, on the following efforts:
- Expanding data submission by voluntary self-insured plans
- Streamlining the data request and approval process
- Modernizing technical infrastructure to reduce costs and improve performance
- Increasing access to user-friendly analytics and data visualizations
- Strengthening partnerships with state agencies, universities, and nonprofits
These initiatives ensure that the APCD continues to deliver value for Connecticut residents and supports the state’s goals of affordability, equity, and transparency.
Why is the APCD an important investment for Connecticut?
Connecticut's APCD, like APCDs in other states, supports informed decision-making across the healthcare system. It allows policymakers, payers, health systems, providers and researchers to:
- Identify cost drivers and trends
- Improve transparency and accountability
- Support access to care for all residents
- Guide reforms that make healthcare more affordable and effective
Healthcare relies on a robust data foundation — and the APCD is Connecticut’s cornerstone for that work.
How much does it cost to operate the APCD?
A vendor-hosted platform customized for Connecticut supports the operation of the APCD. OHS procures these services through a competitive process.
The annual operating cost averages between $1.5 and $2 million, depending on available resources, compliance upgrades and other factors. Operations include:
- Secure hosting and maintenance of over 2 billion claims
- Data ingestion, quality assurance, and submission validation
- Public dashboards and analytic tools
- Privacy and compliance management
- Technical support for state agencies and external users
These costs are consistent with or below those of other state APCDs of similar size and complexity. OHS continually evaluates opportunities to streamline operations, modernize technology, and reduce long-term costs while maintaining high standards for data quality and security.