Frequently Asked Questions

The Nevada All-Payer Claims Database (APCD) is a collection of healthcare claims data from commercial insurance plans as well as public plans, including Medicaid and Medicare, that provide coverage to Nevada residents. Collecting this data, which also includes member and provider information, helps us to better understand healthcare costs, utilization, and quality, providing valuable insights for policymakers, researchers, and the public.

Most people pay for healthcare services by using insurance – whether by getting coverage through their employer, purchasing a plan on a health insurance exchange, or qualifying for a public program like Medicaid or Medicare. Whenever a service is provided using that insurance — an annual check-up, an X-ray or surgery, a filled prescription — the provider and insurer exchange a form (called a “claim”) to finalize the provider's reimbursement. These claims typically include information about why the services were needed, which services were performed, and how much the services cost.

An APCD collects this insurance claims data from a wide range of private and public insurers, performs important quality checks, and creates a comprehensive data resource for states to use. By putting all of this data in one place, APCDs help government agencies, approved analysts, and others track how healthcare use, costs, and outcomes vary across a wide range of factors, including insurance types, provider types, service locations, and patient characteristics like age and sex.

Data collected in the Nevada APCD helps both Nevada residents and the State better understand the cost, quality, and utilization of healthcare services being provided to Nevadans. While the APCD is in its early stages, one can look to other states to see what’s possible: Many states use APCD data to support important public reporting on the costs and availability of common medical services and may allow users to compare costs across health plans, providers, and geographies (learn more here). The data also benefits Nevada residents by informing healthcare policy decisions made at the state level and allowing for data-driven evaluations of existing and future programs.

Recognizing the benefits of having access to comprehensive healthcare data, the Nevada Legislature passed Senate Bill 40 during the 81st (2021) Session of the Nevada Legislature. The bill, which was signed into law on June 7, 2021, allowed for the establishment and implementation of an APCD to collect, manage, and analyze healthcare claims data from payers in Nevada. Mandatory and voluntary APCDs have been established in many states; the first APCDs have now been in operation for more than 20 years.

Nevada's law requires most insurers that provide coverage to 1,000 or more Nevadans to submit data to the APCD. Typical data submissions include:

• Eligibility data (e.g., demographic and administrative information)
• Provider data (e.g., credentials and affiliation information)
• Dental claims (e.g., services and treatments provided)
• Medical claims (e.g., diagnoses and procedures provided)
• Pharmacy claims (e.g., prescriptions filled and brand/generic use)

Onpoint Health Data adheres to industry-leading data privacy standards to protect the confidentiality of personal information and business data. The Nevada APCD data warehouse fully complies with the security standards outlined in the U.S. Health Insurance Portability and Accountability Act (HIPAA) and the U.S. Health Information Technology for Economic and Clinical Health Act (HITECH). Additionally, Onpoint Health Data is certified by HITRUST, an industry-leading standard in health data security that encompasses both federal and state security requirements.

Reports and publications using APCD data can be found within the Explore the APCD section of this website and through the Nevada DHHS Office of Analytics Data Dashboards and Reports Catalog.

Please visit our Contact Us page for more details.

Under state regulations, most health insurers that cover 1,000 or more Nevada residents are required to submit data to the Nevada APCD. Participating plans span a wide variety of insurance providers, including:

• Commercial plans
• Self-insured employer plans
• Marketplace/exchange plans
• Public employee benefits plans
• Medicaid (both fee-for-service and managed care)
• Medicare (both fee-for-service and managed care)

Health insurers that participate in the Nevada APCD must provide data that includes the following (when applicable):

• Eligibility information
• Provider information
• Dental claims
• Medical claims
• Pharmacy claims

Data is submitted on a quarterly basis according to deadlines set and enforced by the State.

Nevada APCD data sets are available to any qualified applicant – the public, researchers, organizations, insurers, healthcare providers, state agencies, and others. Data requestors must submit an application for the data that details how the data will be used, and safeguarded.

Yes. Applicants will be required to attest to their specific usage of the data and cannot attempt to evade privacy restrictions by attempting to re-identify any individual member or members, including by linking Nevada APCD data to other external data sets. Restricted uses of the data will be identified in the data use agreement that must be signed before successful applicants can receive data.

A data use agreement (or "DUA") is a legally binding document signed by the State and the data requestor that establishes the terms and conditions under which Nevada APCD data can be shared and used. Nevada's DUA is intended to protect sensitive information, ensure compliance with applicable laws and regulations (such as privacy laws), and outline the responsibilities of both the State and the data recipient. The DUA addresses issues such as data security, confidentiality, permitted uses, and restrictions to help ensure that data is handled responsibly and ethically and destroyed at the end of the agreement term.

Data is made available according to a timeline and fee schedule developed by DHHS.

Individuals and organizations seeking APCD data must submit a Data Request Form that details their specific need, timeline, and intended use. The request also must specify how the data will be securely stored and either destroyed or returned after use.

Download a request form from Nevada DHHS here.

All data submitted to the Nevada APCD must be "de-identified" prior to submission, meaning sensitive personal information is removed before the data is even submitted so that end users cannot identify an individual or group using the data. To meet this requirement, insurers must remove any personal identifiers before submitting their data. Prior to submission, insurers use a state-approved tool to transform sensitive data into encrypted, non-reversible codes that cannot be decrypted (either by the plans themselves or by the APCD administrator). All files are checked for this security step prior to being processed.

APCD data is shared only with approved data users. Third-party institutions, such as universities or state agencies, may request access to the data through our established Data Request Process and must follow a Data Use Agreement that stipulates how the data will be used, how long the data will be available, and how the data will be secured during use and destroyed upon completion.

Because the data submitted to the Nevada APCD is de-identified prior to submission, it is not possible to connect any of the data contained in the APCD to a specific individual. Additionally, approved data recipients are legally barred from any attempt to overcome the APCD’s privacy safeguards under terms included in their DUA.