All Payers Claims Database

The New Mexico Department of Health (DOH) is conducting a competitive procurement to establish a single contract for developing and managing an All Payer Claims Database (APCD). The RFP seeks a vendor to provide comprehensive services including flat file data collection from healthcare claims payers, data quality assurance, security, Medicare data management, data consolidation, storage, delivery, enhancement, analytics, and reporting. The project requires collecting healthcare claims data from approximately 30 payers, covering 983,000 Medicaid beneficiaries, 408,000 Medicare beneficiaries, and 455,000 commercial beneficiaries. Evaluation will be comprehensive, with 1,000 possible points covering organizational experience, data management, analytics, reporting, privacy, security, and cost. Key deliverables include developing a secure data submission tool, performing data quality assurance, creating patient and provider indices, implementing analytics capabilities, and maintaining a consumer-facing website presenting healthcare cost and quality information. The procurement was posted on October 9, 2025, with proposals due on November 10, 2025, and a pre-proposal conference scheduled for October 22, 2025, via Microsoft Teams. The contract term will be five years with five optional one-year extensions, not to exceed ten years total.

No specific set-aside designations or restrictions for disadvantaged enterprises were explicitly outlined in the provided documentation. The procurement does not indicate an existing incumbent vendor or specific integration requirements with current infrastructure. While the total compensation is not definitively capped, vendors will be required to provide detailed pricing for one-time transition costs and annual maintenance and operations costs. The successful vendor must demonstrate capabilities in developing an analytics environment supporting policy, budget, healthcare payment reform, population health, and quality measurement analyses. Vendors must comply with HIPAA regulations, maintain data privacy, and provide technical support and ad-hoc request capabilities. The project emphasizes cost-effectiveness and innovative approaches to managing a complex healthcare data ecosystem. Potential vendors will need to showcase expertise in data management, technical system requirements, and the ability to handle sophisticated healthcare data analysis across multiple payer sources.