Virginia All Payer Claims Database (APCD)

Description

The Virginia All-Payer Claims Database (APCD), managed by Virginia Health Information (VHI), collects and analyzes healthcare claims data from public and private health insurance providers across the Commonwealth. The APCD offers insights into healthcare utilization, costs, access to care, quality of services, and population health trends. Topic areas include medical and pharmacy claims, provider services, health outcomes, cost and pricing transparency, and healthcare disparities. This comprehensive data resource supports healthcare planning, policy development, and efforts to improve healthcare quality and affordability in Virginia.

How the Community can use the Data

The Virginia APCD helps policymakers, healthcare providers, researchers, and community organizations better understand healthcare utilization, costs, and outcomes across the Commonwealth. Communities can use this data to identify gaps in access to care, analyze healthcare spending and pricing, evaluate the quality of services, and address health disparities. The insights from the APCD support data-driven decision-making, inform health policy, and guide initiatives aimed at improving healthcare quality, affordability, and equity for all Virginians.

Data Limitations

The database includes claims data from participating public and private insurers, but it may not capture services paid out-of-pocket, by non-participating insurers, or provided by uninsured individuals. Claims data reflects billing information rather than clinical detail, which can limit understanding of patient outcomes or quality of care. Additionally, there can be delays in data submission and processing, and variations in coding practices may impact data consistency.