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University of New Hampshire/APCD Council Center

Developing a Robust All-Payer Database in New York

NYHealth awarded a grant to the APCD Council to develop an independent report to guide the State on key policy choices pertaining to the establishment of an all-payer database in New York.

Empowering Health Care Consumers

Grantee Name

University of New Hampshire/APCD Council Center

Funding Area

Empowering Health Care Consumers

Publication Date

May 2018

Grant Amount

$94,084

Grant Date:

March 2015–March 2016

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In 2011, New York State passed legislation enabling the creation of an all-payer database (APD). The APD’s vision is to bring together encounter and payment data from Medicare, Medicaid, and commercial insurers for analysis by the State and multiple stakeholders.

The APD could serve as a resource for price transparency, quality oversight, payment reform, policy research, health systems transformation, and consumer transparency.

However, the APD gained little traction in the five years following the passage of its enabling statute. To stimulate greater action and inform the impending APD regulations, NYHealth awarded a grant to the All-Payer Claims Database Council (APCD Council), which is jointly managed by the University of New Hampshire and the National Association of Health Data Organizations. With this grant, the APCD Council developed an independent report to guide the State on key policy choices pertaining to the establishment of an APD in New York.

Outcomes and Lessons Learned

  • Produced the report “New York’s All-Payer Database: A New Lens for Consumer Transparency,” which demonstrated for State policymakers the choices before them with regard to APD policies related to State authority; price and quality transparency; stakeholder access and use; data release; and governance;
  • Offered lessons learned from other states that have developed (or were developing) similar systems and highlighted the perspectives of key stakeholders in New York State; and
  • Made recommendations for developing a robust APD, including:
    • Develop a phased approach to APD data release based upon stakeholder-driven use cases,
    • Develop consumer price transparency tools,
    • Include self-funded employer claims in the APD,
    • Develop a vigorous stakeholder engagement and communications process regarding the APD startup functions, and
    • Formalize an APD data quality program.

Following the report’s release, NYHealth and APCD Council helped to organize, in conjunction with the APD leadership from the State, a major public stakeholder convening for the APD at the end of 2015. Progress has subsequently been made. The State has issued final regulations; established an office for APCD Council; contracted with a data management vendor; held additional stakeholder convenings to get updates on the APD’s progress and to elicit ongoing input; collected data from health plans; and readied the database platform.

Many of the report’s recommendations have been implemented or are underway, including:

  • De-identified data will be shared through visualizations and dashboards on a public website; they will also be available for download on the New York State Department of Health’s (NYSDOH) website. More limited identifiable data will be available for researchers and other stakeholders. In May 2018, NYSDOH launched the NYS Health Connector website, with interactive data visualizations on health topics such as the cost and quality of hospital procedures, emergency department use, and public health concerns. The State is developing a plan for engaging employer groups to ensure that self-funded data are represented in the APD.
  • NYSDOH is working on several consumer price transparency tools, including Health Nexus, an online tool that will enable consumers to search health care price or quality information, as well as aggregate answers to consumer questions. NYSDOH continues to explore other transparency tool options, and will get feedback from consumer focus groups in fall 2018.
  • The State is finalizing the APD’s governance structure, convening an advisory group this year. It developed a plan with APCD Council for communicating with stakeholders, and has shared updates at three annual meetings in Albany as of May 2018.
  • The State is working across departments and agencies on data quality, improving the encounter intake data, and convening a multistakeholder group on Statewide Planning and Research Cooperative System (SPARCS) data quality that will be foundational for the APD.

Although APCD Council’s role has largely been behind the scenes, its contributions have been significant—New York will be the largest state in the nation with a functioning APD. The initial phase of an operational APD is expected to launch in late 2018.

Co-Funding and Additional Funds Leveraged: Since the NYHealth-funded project closed, the New York State Department of Health has contracted three times with APCD Council for ongoing technical assistance and consultation services ($122,713).

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