MCDB Reports & Use Cases
The Medical Care Data Base (MCDB) supports estimates of cost and utilization, policy analyses, and evaluations of demonstration programs, and is a decision support tool for State partners, such as the Maryland Insurance Administration and the Health Services Cost Review Commission. The MCDB is also made available to researchers to support studies of healthcare utilization, cost, and quality.
Policy & Legislative Reports
The Maryland Health Care Commission (MHCC) reports on a variety of health care data to inform decision making by policy makers, payors, providers, and consumers.
Additionally, the Commission is required to report to the Governor and the General Assembly annually on health care costs, insurance coverage, and the status of the Trauma Fund. The General Assembly often requests one-time or short-term reports from the Commission.
NRHI TCoC Reports
Maryland and other regions across the U.S. participate in the Network for Regional Healthcare Improvement (NRHI) Total Cost of Care (TCoC) national benchmark reporting. TCoC looks at risk-adjusted spending in terms of indices. For example:
- Total Cost Index (TCI) is the product of Resource Use Index (RUI), which measures the amount of health care resources it takes to care for a patient.
- Price Index measures how much a service costs.
The Robert Wood Johnson Foundation (RWJF) funds the TCoC benchmark reporting.
Healthcare Expenditures in Maryland
The MHCC is an independent regulatory agency mandated to report on a wide array of healthcare data. This reporting is essential to inform data-driven decision-making by policymakers, payors, providers, and consumers. Under Maryland Health-General Article §19-133(g) [NEEDS LINK], the MHCC is required to provide annual reports detailing payment levels to physicians and other healthcare practitioners, alongside utilization patterns of healthcare services across the state.
To fulfill these statutory obligations, the MHCC leverages the Maryland Medical Care Data Base (MCDB), as well as various state and federal databases and population surveys. Beyond mandatory reporting, the MHCC performs ad-hoc analyses at its own discretion or in response to specific requests from the Maryland General Assembly (MGA) and other State Agency partners to address emerging health policy concerns.
Statewide Healthcare Spending
The MHCC monitors and reports on total healthcare spending across all sectors in Maryland. These analyses are primarily derived from expenditure estimates provided by the Centers for Medicare and Medicaid Services (CMS) National Health Expenditure (NHE) Data for States.
These reports provide a comprehensive overview of Maryland’s healthcare economy, including total expenditures, per capita spending, and the share of personal income devoted to healthcare. Data is further categorized by service type (e.g., hospital care, physician services, prescription drugs) and payor source (Medicare, Medicaid, and Private Insurance).
Action Required
Stakeholders should review the annual reports and accompanying presentations to understand long-term spending trends and the impact of federal and state policy shifts on Maryland’s total cost of care.
Commercially Insured Spending
In addition to statewide monitoring, the MHCC focuses specifically on health care spending within the commercially insured population. These reports utilize granular data from the MCDB to provide a localized view of the private market.
These reports detail total expenditure, out-of-pocket costs for Maryland residents, and per capita spending trends. They offer critical comparisons across different markets (Individual, Small Group, and Large Group) and types of service. Each annual report typically includes a focused analysis on timely policy issues, such as the impact of benefit design or high-cost specialty drugs.
Action Required
Users are encouraged to download the full reports to access detailed tables and market-specific breakdowns that are not captured in the high-level summaries.
Payments for Professional Services
The MHCC tracks trends in the volume of services and the level of payments made to physicians and other health professionals. This data specifically covers services provided to privately insured, non-elderly residents of Maryland.
These reports are synthesized from healthcare claims and encounter data submitted annually by health insurance plans to the MHCC as part of the MCDB. By analyzing these datasets, the MHCC identifies shifts in practitioner reimbursement and service utilization, ensuring transparency in how professional services are compensated within the state's private sector.
Action Required
To understand the specific shifts in service volume and the nuances of reimbursement rates for various medical specialties, consult the comprehensive annual reports.
Ad Hoc Reports
The MHCC conducts specialized policy analyses and develops reports to support the Maryland General Assembly and other State Agencies in their legislative and programmatic efforts.
These reports address specific mandates or inquiries that fall outside the scope of regular annual reporting. They often involve deep dives into specific sectors of the healthcare system, such as primary care investment, the impact of assignment of benefits legislation, or specific health equity initiatives.
Population Health
The state of Maryland continues to be a leader in value-based payment innovation. The Maryland Total Cost of Care (TCoC) model, an Alternative Payment Model (APM) overseen by the federal government, aims to reduce overall health care costs and improve the health status of all Maryland residents. Part of the MHCC's overall long term strategic priorities is to align the Commission’s goals with the goals of the TCoC model.
One of the goals of the TCoC model requires a focus on population health improvement via various State interventions to prevent or delay the onset of chronic conditions such as diabetes. Hospitals will have an opportunity to receive outcomes-based “credits” for preventing or delaying the onset of chronic diseases like diabetes.
The “Population Health Benchmark Feasibility on the Cost of Diabetes Care” study was conducted to learn whether the MCDB (the commercial data portion of Maryland’s All Payer Claims Database [APCD]) is a viable data source along with the use of the ACG® Software from The Johns Hopkins University for population health studies.
This study used data for Maryland's privately-insured residents under the age of 65, with a focus on the population with Type 2 Diabetes as one example of chronic condition monitoring and assessment.
Contact Us
For questions about the MCDB, please email mhcc.datarelease@maryland.gov.