Nearly a decade before the Affordable Care Act, Maine, Maryland, Massachusetts, New Hampshire and a few other states began creating all-payer claims databases (APCDs). Acting as trusted third parties, they required all commercial insurance carriers within their borders to hand over their claims data, including the prices paid. In the last three years, the number of states investing in these painstaking data collection projects has accelerated. Nineteen states have APCDs in varying stages of development and at least 21 states are considering laws to create them, according to the APCD Council, which assists states in setting up claims databases.