Harness Claims Data to Deliver Value-Based Care
Beneficiary Claims Data API (BCDA) helps organizations deliver value-based care. Using innovative healthcare standards, BCDA enables organizations to integrate Medicare claims data into their tracking, reporting, and performance systems for more coordinated and person-centered care.
Who uses BCDA?
BCDA helps organizations in CMS Alternative Payment Models lower costs and improve beneficiary care. Participating model groups include:
- ACCESS (Advancing Chronic Care with Effective, Scalable Solutions)
- ACO REACH (Accountable Care Organization Realizing Equity, Access, and Community Health)
- GUIDE (Guiding an Improved Dementia Experience)
- IOTA (Increasing Organ Transplant Access)
- KCC (Kidney Care Choices)
- SSP (Shared Savings Program)
BCDA Use Cases
Real-time monitoring and reporting
Track performance, utilization, and shared cost savings with timely insights that support early interventions.
Get claims data in days, not weeks
BCDA claims data is available 2-14 days after submission. This means enrollees can receive time-sensitive care when it matters most. See a timeline of the claims data process.
Fill gaps in patient data
Supplement data from EMRs, ADT feeds, and other sources to get a holistic overview of your enrollees' health histories and provide preventative care.
Receive standardized FHIR claims data
Get interoperable claims data that follows the HL7 Healthcare Interoperability Standard required by Centers for Medicare & Medicaid Services (CMS).
Using the data
BCDA is an Application Programming Interface (API) that updates enrollee claims data at least once a week. Data is provided in NDJSON format and includes:
- Medicare enrollee identifiers
- diagnosis codes
- dates and times of service
Featured
Migrating to v3
The v1 and v2 endpoints will be disabled on July 30, 2027. Review the v3 migration guide for tips on new endpoints, code structures, and other changes to be aware of between v2 and v3.
Announcements
BCDA v3: Expanded access, general availability
Over 600 new organizations are eligible for BCDA in time for v3 general availability.
