Massachusetts All-Payer Claims Database

MA APCD Calendar Year 2023
(2019-2023 data with six-month run out from 2024)

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

The claims data sets sent to CHIA cover a number of services, including: medical, pharmacy, dental, vision, behavioral health and specialty services. Submitters also send detailed files on their insurance products, affiliated providers and benefit plans.

Please visit CHIA’s Regulations page for more detailed information on who is required to submit data and what data they must submit.

Health plans, researchers, and others use the MA APCD to analyze and report on population health management, quality outcomes, costs and pricing variations. To learn more about how MA APCD data is used, view historical applications for data that CHIA has received from researchers and other entities. You can also review a sample of both internal and external research using MA APCD and Case Mix data.

Annual Release Overview

CHIA’s APCD annual releases contain five years’ worth of claims. To ensure completeness of the data set, CHIA includes claims submitted during the first six months of the current year that relate to services provided during the five-year release period. CHIA refers to this six-month period as the “run-out period.” For example, MA APCD Calendar Year 2023 includes claims, eligibility, provider, and other required file types submitted for calendar years 2019-2023, plus claims related to services provided in those years that are processed between January and June 2024. 

The release process includes:

• • 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.

• • 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, creation of derived fields and filters, and other enhancements. This process can take from eight to twelve weeks depending on whether we identify issues during testing.

• • Quality and Release Assurance Testing
    Before an annual release is finalized, CHIA’s quality assurance team performs an eight to ten 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 eight 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.

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