Maine All Payers Claims Database

NORC is working closely with our partner, the Human Services Research Institute (HSRI), to improve and transform the Maine Health Data Organization’s (MHDO) All Payer Claims Database (APCD). Specifically, we are developing and implementing a new and improved process for collecting and utilizing the state’s healthcare claims data, including encounter and eligibility data, hospital financial data, and information related to all physical health, dental, pharmacy, behavioral health, and disability-related services. For example, we developed a customized data intake system that validates data submissions and reduces the burden on payers by flagging errors in real time and identifying corrective actions. Payers may also receive technical assistance from the MHDO help desk. Once validated, cleaned, and fully quality assured the data are loaded into to a backend database and prepared for future statistical, analytical, and reporting purposes.

We also developed a public reporting website (www.CompareMaine.org), which is one of the only health transparency sites in the nation that presents quality ratings alongside cost information. The site, for which MHDO was awarded the distinguished 2016 Data Dissemination Award by the National Association of Health Data Organization (NAHDO), shows how patients rank their overall experience and how Maine hospitals compare with one another across nearly 250 medical procedures from 240 healthcare facilities, including hospitals, surgical centers, diagnostic imaging centers, labs, and clinics. What’s more, the Catalyst for Payment Reform and the Health Care Incentives Improvement Institute’s jointly released report card on price transparency laws identified Maine as one of only three states in the nation to receive a grade of “A” in 2016.