Since 2003, MHDO has been collecting health care claims data per the requirements defined in Rule Chapter 243.
The entities that are required to submit claims data include: insurance companies and third party administrators. There are eligibility threshold levels described in Rule Chapter 243 that have changed over the years. MHDO also receives data from the state’s Medicaid Program-MaineCare and Medicare data from CMS.
Claims data submissions include files with member eligibility, medical claims, pharmacy claims, and/or dental claims information. Key highlights of some of the data elements are: detailed diagnosis, procedure, payment, and provider and geographical information. Releasable elements will vary depending on the data requested. Data dictionaries are also available with in-depth detail about what is contained in the claims data. In addition, reports that other data users have created are available as samples of possible analysis.
The interactive dashboard below provides details about the MHDO data that are available. You can navigate to different views (or pages) using the buttons on the left side.
Since 1990, MHDO has been collecting hospital inpatient and outpatient encounter data per the requirements defined in Rule Chapter 241.
Some of the data elements in the hospital inpatient and outpatient (including provider based clinics) encounter file are diagnosis, procedures performed, payer, hospital or clinic code, DRG, patient characteristics and geographical data. The Data Dictionary is available and includes in-depth detail about elements contained in the hospital encounter data. In addition, reports that other data users have created are available as samples of possible analysis.
The interactive dashboard below provides details about the MHDO data that are available. You can navigate to different views (or pages) using the buttons on the left side.
The data request process can be found on our Request Data or Reports page. Please see details on different types of data requests and the process for the release of data.
Please see our FAQs if you have additional questions.
The table below provides a summary of the data MHDO has available and the time period covered. Be sure to check our Data Release Schedules page for a more recent release that could be right around the corner.
| Data Set | Governing Rule | Who Provides the Data? | What's in the Data? |
Data Status
(updated December 22, 2023) |
|---|---|---|---|---|
| Claims - APCD | Chapter 243 |
|
|
Currently available:
|
| Hospital Data | Chapter 241 | Maine Hospitals | Since 1990, all services provided by hospitals and provider based clinics in Maine (includes historical information from the Maine Health Care Finance Commission). |
|
| Ch. 270 Quality Data | Chapter 270 | Maine hospitals and Quality Improvement Organization (QIO) |
Since 2005:
|
Nursing Sensitive Patient Centered (NSPC) quality metrics (NSPC-1, NSPC-2 & NSPC-3) through March 2023 CLABSI and MRSA blood specimen Lab ID Events data through December 2022 Clostridium difficile Lab ID Events data through December 2022 |
| Hospital Financials | Chapter 300 | Maine Hospitals |
Since 1994, unconsolidated hospital audited financial statements. (2006 introduced standard reporting
template for financial reporting). Consolidated Health System audited financial data collected and published beginning with FY 2021. |
Currently available are data through FY2022 (data is collected based on hospital fiscal year). |