Frequently asked questions about the APCD

  • What is an All-Payer Claims Database or APCD?

    An All-Payer Claims Database is a repository of healthcare, pharmacy, and dental claims data from both private and public payer sources across the state. An APCD also includes eligibility and other publicly available data to create a comprehensive, longitudinal multi-payer dataset in order to provide the greatest opportunities for improving the healthcare delivery system.

    An APCD will allow public and private health care purchasers and consumers to identify and compare: health plans, health insurers, health care facilities, and health care practitioners which provide safe, value-based, cost-effective, high quality healthcare services. Georgia’s APCD will promote cost and quality transparency, assess geographic variations in price and utilization, track healthcare spending drivers and trends, and promote public health.

  • Will providers be required to submit data?

    ​​​​​​No, healthcare claims data will only be submitted by healthcare payers / insurance companies.

  • How many APCDs are operated, nationwide?

    As of December 2023, there are 27 states with active APCDs.  A good source of information about national APCD efforts is https://www.apcdcouncil.org/state/map.

  • Is Georgia aligning with national APCD efforts?

    Georgia is aligned with and following the standards established by the APCD Council, which is convened and coordinated by the Institute for Health Policy and Practice (IHPP) at the University of New Hampshire (UNH) and the National Association of Health Data Organizations (NAHDO).

  • Who is required to submit data to the APCD?

    Many different entities may submit data to the APCD, either voluntarily or through a statutory requirement. Insurance companies, medical services plans, hospital plans, hospital medical service corporations, health maintenance organizations, and fraternal benefit societies with at least 1,000 covered lives in the previous calendar year will submit data. The Department of Community Health and Medicaid Care Management Organizations, the State Health Benefit Plan, and numerous other agencies are required to submit data. While certain plan types, such as those subject to ERISA, are not required to submit data, they may choose to do so voluntarily. 

  • Who is not required to submit data to the APCD?

    ​​​​​​Submitting entities do not include an entity that provides health insurance or a health benefit plan that is accident-only, specified disease, hospital indemnity, long-term care, disability income, or other supplemental benefit coverage.

    Plans subject to ERISA may voluntarily submit claims to the APCD. Employers can also elect to opt-in to the APCD by submitting a written request to their plan providers. 

  • What data are collected?

    ​​​​​​“Claims data” means information included in an institutional, professional, dental, or pharmacy claim or equivalent information transaction for a covered individual, including the amount paid to a provider of health care services plus any amount owed by the covered individual. Claims data may also include related information about a patient, provider, or health plan which is utilized by the payer to process the claim.

    For more information on what data are in the APCD, visit Data & Reports.

  • Does the APCD contain patient names or identifying information?

    The APCD does not store patient identifiers such as social security number, name, or address. All patients are de-identified before being loaded into the state’s analytic environment. In addition, any attempt to re-identify patients from APCD data is strictly prohibited.

  • How is the information in the APCD protected?

    Data in the APCD is protected physically, technically, and administratively. Access controls to the data are strictly limited to minimally necessary staff with appropriate training and clearance. Analysts are prevented from intentionally or unintentionally removing detailed information from the storage environment. State of the art software and hardware solutions are in place to further protect the data.

  • Who runs the APCD?

    ​​​​​​By statute, the APCD is a collaborative effort between the Georgia Office of Health Strategy and Coordination (OHSC) and the Georgia Tech Research Institute – Center for Health Analytics and Informatics (GTRI-CHAI).

  • How can information from the APCD be accessed?

    Visit Data & Reports.  Public data including Dashboards, Public Reports, and Public Use Files (PUFs) will be made available under Public Data on the APCD website in early 2024.  For those interested in other data, find out more about the planned process for requesting Non-Public Data and Custom Reports.