All-Payer Claims Databases (APCDs) have been established by states to address the national and local healthcare challenges such as the rise in healthcare cost, population health, quality of care and access to care. The State Health Planning & Development Agency (SHPDA) has designated the Pacific Health Informatics and Data Center (PHIDC) as the data center for the Hawai‘i APCD. This collaboration with the State Health Planning & Development Agency (SHPDA), Department of Health (DOH), Department of Human Services Med-QUEST Division (Med-QUEST), Hawai‘i Employer-Union Health Benefits Trust Fund (EUTF), Office of Enterprise Technology Services (ETS), Department of Commerce & Consumer Affairs (DCCA), Department of Budget & Finance (B&F), and the University of Hawai‘i (UH), aims to inform consumers and policymakers of the healthcare costs, population health, and healthcare system of Hawai‘i.

In 2013, the State of Hawai‘i received a grant from the Center for Consumer Information and Insurance Oversight (CCIIO) of the Centers for Medicare and Medicaid Services (CMS) to establish a data center.  In 2016, Governor Ige signed Act 139 (16) Relating to Insurance into law, which designated SHPDA as the lead agency for the Hawai‘i All-Payer Claims Database and mandated data submission by Med-QUEST and the Hawai‘i EUTF, and their health plans to SHPDA.

In 2018, Act 55 (18) Relating to Health was signed into law which established the Health Analytics Program in the Med-QUEST Division of the Department of Human Services (DHS). The bill continues the support of the APCD activities in collaboration with SHPDA, DOH, DCCA, Hawai‘i EUTF, and the UH. Utilizing the authority of SHPDA, this bill allows for the continued support and operational maintenance of the APCD.

TASI/PHIDC was selected by the State in part, because of its role as an academic center with health information technology, healthcare analytics policy, and economics.  Additionally, TASI/PHIDC was selected to serve as the data center for the Hawai‘i APCD in part because of a requirement that the data center be established in an academic or non-profit institution and that the organization be free of any conflicts of interest.  As the data center, PHIDC will collect and manage; cleanse and store; validate and match the data; and conduct data analysis and prepare reports.

The main analytic objectives of the Hawai‘i All-Payer Claims Database includes:

  • Establish baseline information
  • Monitor and analyze healthcare costs
  • Assess population health
  • Measure utilization of services
  • Identify health disparities
  • Inform consumers of cost and quality of healthcare
  • Support planning and evaluation of healthcare operations and care
  • Improve coordination of care
  • Enable oversight of health insurance premium medical loss ratios
  • Waste, fraud and abuse studies
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The Hawai‘i Health Data Center (HHDC) All-Payer Claims Database (APCD) is funded by grants from the Centers for Medicare and Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight (CCIIO).

Regulations

Act 139 (16)

This statute authorizes the SHPDA to mandate the reporting of administrative data by providers of health insurance that provide health benefit plans funded by the Hawai‘i EUTF and Med-QUEST.

SHPDA Interim Administrative Rules §11-188

The SHPDA Interim Administrative Rules §11-188 govern the submission of administrative data by providers of health insurance that provide health benefit plans funded by the Hawai‘i EUTF and Med-QUEST to SHPDA. 

Act 55 (18)

This statute establishes the Health Analytics Program in the Med-QUEST Division of the Department of Human Services (DHS) and continues the support of the APCD activities in collaboration with SHPDA, DOH, DCCA, Hawai‘i EUTF, and the UH. Utilizing the authority of SHPDA, this bill allows for the continued support and operational maintenance of the APCD.

Resources

FY 2019 SHPDA Annual Plan

The FY 2019 SHPDA Annual Plan provides an overview of the HHDC APCD project goals and activities for the upcoming fiscal year.

Reports

Coming Soon!