Minnesota's APCD Workgroup Recommends Actions to Expand Overall Use of Program

The Minnesota Department of Health (MDH), directed by the state’s All-Payer Claims Database (APCD) Workgroup, recently published a report to the Minnesota Legislature containing a summary of recommendations to develop a framework for the expanded uses of the Minnesota all-payer claims database (MN APCD) – sometimes called the Minnesota Health Care Claims Reporting System (MHCCRS) for data intake purposes. The report, which represents the opinions of a wide variety of stakeholders, including healthcare professionals with extensive knowledge of Minnesota’s health systems, was the APCD Workgroup's response to several questions from the Legislature regarding the future functionality of the MN APCD. 

The MN APCD was created by the state’s Legislature in 2008 and has been developed and operated by Onpoint since 2009. The program was designed specifically to support the state’s Provider Peer Grouping (PPG) initiative and its efforts to “increase transparency about value in purchasing by publishing reports on health care cost and quality in Minnesota hospitals and clinics.” While the PPG initiative was suspended in 2014, the Legislature expanded the authority for the MDH to use the MN APCD for a select number of additional projects, including studying variation in cost, quality, utilization and disease burden; evaluating the healthcare home program and the State Innovation Model initiative; leading a study of chronic pain management services; conducting analysis with partners on preventable readmissions; and exploring the feasibility of using the data for state-based risk adjustment. It was this 2014 legislation that also required the Commissioner of Health to convene the APCD Workgroup to make recommendations for further uses. 

With consensus that the MN APCD is “an important, publicly funded resource that can help Minnesota move towards achieving the Triple Aim” — improving the patient’s experience of care, improving the health of populations, and reducing the per-capita cost of healthcare — the APCD Workgroup’s report recommends that the Legislature move iteratively, initially by beginning to expand the use of the APCD by creating Public Use files and summary tables. (These files would not require any additional permissions or approval processes.)   

To move beyond these additional first steps, the APCD Workgroup suggests establishing two guiding teams to maximize the utility of the MN APCD: (1) a broad governing body to handle policymaking and data use requests and (2) a technical group to contribute specialized expertise about the database. As “new health care strategies, analytic technologies, and service models emerge,” these bodies could guide the MN APCD down various innovative analytic avenues — e.g., supporting longitudinal studies, integrating behavioral health data with physical health claims data, etc. — to foster insight regarding variations and disparities in care, measure quality of care, and inform price transparency and other initiatives.   

The next legislative milestone for the MN APCD will be when the MDH provides a series of reports analyzing the APCD data and examining aspects of data quality. 

To read the APCD Workgroup's report, please click here.