Colorado
Title or Name of APCD System:
Colorado All Payer Claims Database
Category:
Existing
Who Maintains the System:
Center for Improving Value in Health Care (CIVHC)
Website:
First Year APCD Collected Data:
2012
APCD Snapshot:
In 2010, HB 10-1330 passed creating the state-mandated CO APCD. The bill was passed without state appropriated funding attached to the bill. Colorado’s Medicaid agency, the Department of Health Care Policy and Financing (HCPF), named the non-profit Center for Improving Value in Health Care (CIVHC), administrator of the CO APCD. CIVHC received private grant funding for CO APCD planning and implementation from The Colorado Trust and the Colorado Health Foundation. The HCPF-appointed CO APCD Advisory Committee helped CIVHC develop policies and procedures for implementation and the initial public reporting framework. In early 2012, data management vendor Treo Solutions (now 3M) began collecting and processing three years of historic claims information from Medicaid and the largest volume commercial payers. In November 2012, CIVHC launched the first interactive reports on the CO APCD public website, and in January 2013, CIVHC began releasing custom data requests through their HIPAA/HITECH-compliant data release process. In July 2017, CIVHC transitioned to new data warehouse and analytic partners, HSRI and NORC. The CO APCD now contains over 500 million claims from Medicaid, Medicare, Medicare Advantage and the 21 largest commercial health plans, representing over 80% (4+ million) insured Coloradans.
Number of Commercial Sources of Claims Data:
33 (as of May 2018)
Covered Lives:
4.3 million unique lives (as of May 2018)
Sources and Status of APCD Data Collection
Payers | Currently Collected | Planned Collection |
---|---|---|
Commercial Payers | Yes | -- |
Third Party Administrators/Self-Funded | Yes | -- |
Medicaid | Yes | -- |
Medicare | Yes | -- |
Other | Medicare FFS and Medicare Advantage |
Types of Data Collected | Currently Collected | Planned Collection |
---|---|---|
Medical Claims | Yes | -- |
Eligibility | Yes | -- |
Dental | Yes | -- |
Pharmacy | Yes | -- |
Primary Users/Uses:
Consumers, State Agencies, Researchers & Academic Institutions, Hospitals, Providers, Government Officials & Legislators, Employers and Health Plan Brokers, Non-profits, and Digital Healthcare companies.
Future Plans:
In 2017 and beyond, CIVHC is planning to engage ERISA-based self-insured plans for voluntary submission and is developing a new website with expanded public reporting of comparative cost, quality, utilization and prevention information.
Consumer Website:
State Specific Resources:
Cost Driver Spot Analysis: Regional Price Variation for High Volume Services
Utilization Spot Analysis: Free Standing Emergency Departments
CIVHC State Agency vs Qualified Entity Comparison Document
Antitrust Legality of Reports and Analytic Data Sets Generated based on APCDs
Avoidable Emergency Department Use
Average Paid Amounts for Common Health Conditions
C-Section Reduction Could Save $6.5 Million Annually
Medicaid Frostbite Claims with Subsequent Amputation Dx within 7 Days
ED Severity Levels by Line of Business
High Risk Pool Cost Comparison, CO, NH, VT
EpiPen Prescription Cost Trends, 2009-2016
Trends in Teen Pregnancy Rates for Health First CO, 2009-2014
Contact Information:
For more information please contact info@civhc.org.