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 16 - 20 of 79

Use Cases Category Carriers
Analysis of proposed legislation to provide dental coverage for individuals with head and neck cancers
The Colorado Division of Insurance (DOI) commissioned Milliman, Inc. to review a potential legislative proposal that would require all commercial health benefit plans in the individual, small group, and large group markets to cover dental care and certain other medically necessary procedures for individuals with certain head and neck cancers as part of the health benefit plan
 Insurance Department Commercial
Comorbidity and Multimorbidity in Adults With Congenital Heart Disease: Findings From a Multi‐Site Population‐Based Study
This study leverages the CO APCD and other state data resources to study Congenital Heart Disease comorbidities in adults living with the condition.
 Population Health Commercial
Small Intervention, Big Impact: Health Care Cost Reductions Related to Medically Tailored Nutrition
Food is a critical aspect of health care for people living with illnesses like congestive heart failure, chronic obstructive pulmonary disease, and diabetes. Unfortunately, lack of disease-specific nutrition knowledge, low energy, and financial constraints due to hospital bills, co-pays, emergency department visits, and medications can make eating right especially challenging for people managing illness. Many end up being hospitalized due to malnutrition or other nutrition-related complications.
 Consumers, Health Reform, Insurance Department, Population Health, Providers
CO APCD Annual Report 2016
Colorado's All Payer Claims Database (APCD) released its 2016 annual report detailing the organization's success in advancing the triple aim of better health, better care, and lower costs. This report includes information about the sustainability of the CO APCD, showcasses several organizations who utilized CO APCD's data to better the health of Coloradans, and lists recommendations for the Colorado General Assembly.
Consumers, Employers, Health Reform, Insurance Department, Population Health, Providers, Researchers Commercial
Cost Driver Spot Analysis: Regional Price Variation for High Volume Services January 2017
The Center for Improving Value in Health Care (CIVHC) analyzed 2014 commercial claims data for high volume procedures in six regions of Colorado to consider the relationship between cost variation, volume, and geography. CIVHC found that there is no definite correlation between the factors and that the root cause of regional payment variation has not been identified. Residents of a certain region may pay more for a particular procedure, but do not generally pay more for all health care services.
 Consumers, Employers, Providers, Researchers Commercial