Technical note for the HCAI Healthcare Payments Data (HPD) Medical Out-of-Pocket Costs and Chronic Conditions (2022).

HPD Medical Out-of-Pocket Costs and Chronic Conditions Technical Note (2022 Data) - March 2025

Healthcare Payments Data (HPD) Medical Out-of-Pocket Costs and Chronic Conditions

This field identifies the county associated with the member’s residence.

County Name

Product payers are the companies, programs, and organizations that oversee insurance plans and reimburse healthcare providers. The three main types of payers are Commercial, Medi-Cal, and Medicare.

Insurance Product Payer Type on Medical Claim

This field is used to identify people with and without chronic conditions.

Chronic Condition Flag

This field is used to identify people with one chronic condition or multiple chronic conditions.

Number of Chronic Conditions

This field is used to identify 23 different chronic condition types.

Chronic Condition Types

Annual member count for people with medical claims.

Annual Number of Members

Annual median out-of-pocket cost. It includes copay, coinsurance, and deductible.

Annual Median Out-of-Pocket Cost

The 25th percentile of annual out-of-pocket cost.

Annual 25th Percentile of Out-of-Pocket Cost

The 75th percentile of annual out-of-pocket cost.

Annual 75th Percentile of Out-of-Pocket Cost

Annual Median Claim Count

The 25th percentile of annual claim count.

Annual 25th Percentile of Claim Count

The 75th percentile of annual claim count.

HPD Medical Out-of-Pocket Costs and Chronic Conditions Technical Note (2022 Data) - March 2025

Preview

Data dictionary

API endpoint

Dataset Name