Massachusetts All-Payer Claims Database

MA APCD

Overview

The Massachusetts All-Payer Claims Database (MA APCD) is the most comprehensive source of health claims data from public and private payers providing health care coverage to Massachusetts residents and employees. The MA APCD includes:

  • Medical
  • Pharmacy
  • Dental
  • Vision
  • Behavioral Health
  • Specialty services

The MA APCD also includes detailed files on insurance products, affiliated providers and benefit plans.

Health plans, hospitals and other researchers use the MA APCD to analyze and report on population health management, quality outcomes, costs and pricing variations.


Request APCD Data

Find step-by-step instructions and support information to apply for a MA APCD data extract.

Submit APCD Data

Find resources, requirements and instructions for submitting payer data to CHIA, including claims and member eligibility.

Annual Release Process

MA APCD releases contain 5 years’ worth of claims. To ensure completeness, CHIA includes claims submitted during the first 6months of the current year relating to services provided during the 5-year release period. CHIA refers to this 6-month period as the “run-out period.”

For example, MA APCD Calendar Year 2024 includes claims, eligibility, provider, and other required file types submitted for calendar years 2020-2024, plus claims related to services provided in those years that are processed between January and June 2025.

1

Data Intake and Internal Processing

CHIA works with approximately 60 Massachusetts APCD organizations to ensure valid, high-quality monthly data submissions. Payers must deliver their submission files within 30 days after the end of each month.

CHIA runs each file through a series of file- and field-level edits to confirm formatting and to check for data quality issues. CHIA notifies payers if their file(s) do not pass these intake edits so that they can correct and resend them. If data submission fixes are required, submitters spend additional time fixing, validating, and resubmitting data files.

2

Release Creation

Following receipt of all files, CHIA loads the data into the APCD Data Warehouse and performs a series of steps, including data standardization, data cleaning, claims versioning, and creation of derived fields and filters, among other enhancements. This process can take 8 to 12 weeks depending on whether issues are identified during testing.

3

Quality and Release Assurance Testing

Before an annual release is finalized, CHIA’s quality assurance team performs an 8- to 10-week quality assurance validation process to test the completeness and quality of select fields as well as any new product features and enhancements. If updates are required as a result of testing, CHIA performs comprehensive regression testing.

After completing quality assurance testing, CHIA’s release assurance team spends approximately 8 weeks validating the data creation process and ensuring data completeness and accuracy. We then extract the most recent data to create the annual APCD Release Data Mart, which becomes the source for all data extracts.

4

Delivery of Data Extracts

CHIA extracts data from the APCD Release Data Mart to create extract files for its customers. It can take 5 to 7 days to create an extract file. CHIA prioritizes delivery of extracts to Commonwealth agencies doing research in support of health care policy. Second priority is given to organizations that submit data. Third priority goes to independent researchers.

See Data Request Status

MA APCD Documentation Archive