Colorado
Category
Title or Name of APCD System
  • Colorado All Payer Claims Database
Who Maintains the System
  • Center for Improving Value in Health Care (CIVHC)
Website
Legal Authority
Investment
  • $3.8 million annual operating budget
Statute
Submission Rules
Release Policy
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
Covered Lives
  • 4.3 million unique lives (as of May 2018)
Sources and Status of APCD Data Collection
Payers
Commercial Payers
  • Currently Collected
Third Party Administrators/Self-Funded
  • Currently Collected
Medicaid
  • Currently Collected
Medicare
  • Currently Collected
Other
  • Medicare FFS and Medicare Advantage
Types of Data Collected 
Medical Claims
  • Currently Collected
Eligibility
  • Currently Collected
Dental
  • Currently Collected
Pharmacy
  • Currently Collected
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.
Consumer Website
Related APCD Activity

  • Public reporting (website interactive facility price & quality, and population health total cost, utilization, chronic conditions, and appropriate care; spot analysis, data bytes, white papers and annual reports); Custom data provided through data release review committee to stakeholders advancing the Triple Aim (researchers, non-profits, payers, providers, employers, etc.).

Contact Information

Use Cases from the APCD Showcase

Displaying 11 - 15 of 79

Use Cases Category Carriers
Insurance gaps at age-19 and age-26 health insurance eligibility thresholds by childhood-onset condition severity, Colorado 2014-2018
This case study examines health insurance coverage gaps among Colorado young adults at two age-based cutoffs — losing Medicaid at 19 and aging off parental coverage at 26 — finding that coverage gaps spike around both birthdays, affecting roughly 9% of enrollees within six months of each threshold, and concluding that these transition points need greater policy attention.
 Consumers, Employers, Providers Commercial, Medicaid
Exogenous Testosterone Is Associated with Lower Odds of Stroke in Young Men: An Exploratory Analysis of the Colorado Claims Database
The abstract reports that establishing a stroke transition-of-care clinic — where patients are seen by neurology within two weeks after hospital discharge — was associated with a significant reduction in 30-day hospital readmission rates for ischemic and hemorrhagic stroke patients, suggesting improved follow-up care can enhance outcomes.
 Population Health Commercial
Curbing the Growing Fragmentation of Veterans’ Health Care
This study quantifies a major shift in locus of VA critical care, a likely outcome of expanded non-VA health insurance coverage that was previously called out, but the study was not designed to address the many issues raised by outsourcing so much ICU care, including questions about the coordination and continuity of post-ICU care for these patients with high-acuity conditions. The study adds to concerns about VA’s ability to oversee the quality of community care and gaps in the integration of VA-delivered and VA-purchased care.
 Consumers, Health Reform, Medicaid, Population Health, Providers Medicaid
State Efforts To Monitor Outpatient Facility Fees
Colorado, Maine, Connecticut, and Washington—have collected and analyzed data on outpatient facility fee billing within their borders. This growing interest reflects several converging trends. Hospital outpatient utilization has increased substantially over the past few decades, and care delivered in HOPDs has generally become more expensive compared to similar care provided in non-hospital settings.
Consumers, Providers, Researchers Commercial
Z-Coding for Social Contributors to Health in Colorado Federally Qualified Health Centers
This study looked at the prevalence of social contributor Z codes for patients receiving services through Colorado’s Federally Qualified Health Centers (FQHC). The study compared utilization and cost among patients with and without Z code documentation, finding patients with health Z codes had higher predicted annual medical expenditures. Low prevalence of Z code usage was also noted, highlighting the need for improved documentation related to social contributors of health.
Consumers Commercial, Medicaid