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Statewide all-payer claims databases (APCDs) continue to capture national interest, with 26 states having implemented or started implementation of these health information systems. By including both public and commercial claims, an APCD allows policymakers and other health care stakeholders to access better and more comprehensive data; improve quality health outcomes; and promote equity through the consideration of social determinants of health. All of these strengthen the ability of those that use, provide, and pay for health care services to make informed decisions. 

The Need for an APCD:
During the last decade, the Midwest Health Initiative (MHI) has built and sustained the largest, voluntary, commercial payer claims dataset for the state of Missouri and the surrounding metropolitan areas. Guided by leaders from the region’s largest health plans, health systems, and health care purchasers, MHI has had success in leveraging trusted information and shared accountability to solve the most pressing health care challenges, while balancing considerations for access, quality, and cost. All Missourians could benefit if this system were to expand to include claims paid by all payers, not just the commercial sector.

The Research Project:
In 2020, MHI leaders and community partners expressed a shared interest in the creation of an APCD for the state of Missouri. Funded by Missouri Foundation for Health, independent consultants sought insights from over 270 Missouri constituents. The resulting Health Information Blueprint for Missouri provides a framework for stakeholder engagement, use cases, governance, funding, and technical considerations to build a valuable health information asset for our state. Objectives of this project included:

  1. Understand current health information organizations and assets in Missouri,

  2. Assess the appetite for the development of an APCD for the state, and

  3. Identify collaborators and champions for achieving this vision in the future.


Click here to view report

We are grateful to all who contributed to the report’s content. As a Centers for Medicare and Medicaid Designated Qualified Entity, and with access to existing commercial claims data, MHI stands ready to share insights; work collectively with others toward better health and higher value health care; and support or lead efforts to realize an APCD able to serve all Missourians. We look forward to receiving feedback to inform next steps. Please contact MHI Executive Director, Louise Probst, for further information, to offer suggestions, or to lend your support.


For more information, to offer suggestions, or to lend your support, please contact MHI Executive Director, Louis Probst, at


How Does an APCD
Benefit Missourians?

How Does an APCD Balance Big Data Utility and
Individual Health Privacy?

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