NCPA staff Joel Kurzman had an introductory meeting with the Center for Health Information and Analysis (CHIA), an independent agency in Massachusetts that serves as the commonwealth’s primary hub for health care data, to discuss its collection of PBM data. Among its diverse projects and initiatives, CHIA was granted authority by 2024 legislation to require PBM reporting, the details of which were determined in a rulemaking. CHIA’s first public report is expected in October.
CHIA collects commercial market data from both fully insured and self-insured health plans; by contrast, other all-payer claims database organizations can only require collection of fully insured data due to ERISA constraints. The agency’s PBM data collection process is overseen by its Oversight Council, which meets regularly and collaborates with the commonwealth’s Department of Insurance.
Of note, CHIA has a process by which state agencies, providers, payers, and researchers can apply for and use the data for research in the public interest. NCPA will continue to meet with CHIA and explore opportunities to collaborate on PBM data collection and identify ways to bring visibility to opaque PBM business practices.
