All Payer Database
Transforming health care to address cost, access and quality issues requires a broader view of population health and the performance of the health care system than current resources permit. To allow for the collection of information that can strengthen health care planning and decision-making, New York State signed into law legislation to create the All Payer Database (APD).
The APD will store data which is collected from all major public and private payers, such as insurance carriers, health plans, third-party administrators, pharmacy benefit managers, Medicaid, and Medicare. In addition, the APD will enhance existing New York State Health Department (DOH) databases including the Statewide Planning and Research Cooperative System (SPARCS) and the Medicaid data warehouse. SPARCS collects clinical and demographic information on all hospital discharges, emergency department visits, ambulatory care visits and hospital outpatient service visits.
For more information on the APD, see section 2816 of the Public Health Law.
What the APD will Do
The APD will support the researching, planning, executing, monitoring, and regulating of health care reform and health care initiatives in an efficient and cost effective manner. The APD will serve as a foundation for the development of analytics, services, and products to all health care system stakeholders, including policy makers and consumers.
Listed below are the types of information that will comprise the APD:
- Commercial payer data
- SPARCS data (facility discharge data)
- Medicaid and Medicare data
- Public Health Repositories (e.g. cancer registry, immunization registry)
- Lab and Electronic Health Record (EHR) data
The APD will be designed to support the implementation of an information platform that could support the evolving needs of the health care system. DOH envisions the APD to be more than just a data warehouse for commercial claims and discharge data. Also, DOH intends to create a scalable, extensible information platform that will enrich claims and discharge data by integrating and linking it with other sources of health information. By integrating and linking with data from Medicare, public health databases, and the Statewide Health Information Network for New York (SHIN-NY), it will be possible for the APD to provide a more complete and comprehensive source of information needed by all participants in the health care system from policy makers to clinicians to consumers.
The APD will enable the evaluation of critical issues such as regional variations in utilization, quality, and cost. It can also examine the impact of reimbursement policies and procedures, public health interventions, and health care resources on utilization, quality, outcomes, and costs. The APD will provide a better understanding of the health care costs by evaluating the charges and expenditures across payers, providers, and communities. When this data is publicly available, consumers will have the knowledge they need to compare cost and quality for important health care decisions. In addition, feedback to providers can lead to improvement in performance and quality.
The New York State Health Department received funding from the Health and Human Services (HHS) Exchange Establishment Grant to support the Health Benefits Exchange, including enhanced risk adjustment, providing the Exchange with data on quality and cost, and providing the Department of Financial Services with data to assist in reviewing and approving premium rate increases by providing valuable comparative information between plans.
Collaboration with External Stakeholders
DOH has been working closely with external stakeholders to gather input to establish the APD. Many representatives from health plans, provider organizations, researchers, and other interest groups participate on the APD Steering Committee which meets on a quarterly basis. In addition to these activities, DOH will continue to inform stakeholders of progress through updating this site and by distributing information using the below listserv.