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 26 - 30 of 79

Use Cases Category Carriers
EpiPen Prescription Cost Trends
The Center for Improving Value in Health Care (CIVHC) analyzed trends in EpiPen prescription costs from 2009-2016 for Medicaid and commercial payers. For both insurance types, the median paid amount for an EpiPen prescription has been steadily increasing with each consecutive year. Analysis is based on claims data in the Colorado All-Payer Claims Database (APCD).
Consumers, Employers, Insurance Department, Medicaid, Researchers Commercial, Medicaid
Cost of Covering Individuals in High Risk Pools in 2015
The Center for Improving Value in Health Care (CIVHC) compared the cost of covering individuals under 65 in high risk pools in 2015 between Colorado, New Hampshire, and Virginia. Individuals in high risk pools are defined as those who make up the top two percent of claims. In terms of per person per year cost, Colorado spent approximately $77,900 on those in the high risk pool.
 Employers, Insurance Department, Population Health, Providers, Researchers Commercial
Data Byte: Emergency Department Severity-Level Trends by Line of Business
The Center for Improving Value in Health Care (CIVHC) used 2009-2016 claims data from the Colorado All-Payer Claims Database (APCD) to examine trends in emergency department utilization by severity and payer type. The percent of moderate severity and low to moderate severity claims appears to decrease for both Medicaid and commercial payers during the observed time period.
 Consumers, Health Reform, Medicaid, Population Health, Providers, Researchers Commercial, Medicaid, Medicare
Average Paid Amounts for Common Health Conditions: Free-standing ER vs. Urgent Care Facility
Colorado's Center for Improving Value in Health Care (CIVHC) examined trends in the average paid amount for common health conditions at urgent care facilities compared with free-standing emergency rooms. Commercial claims data from 2014 was analyzed. The average paid amount to free-standing emergency rooms was higher than that to urgent care facilities for all conditions listed.
 Consumers, Health Reform, Insurance Department, Providers Commercial
Interactive Colorado Cost of Care Report
Colorado's Center for Improving Value in Health Care (CIVHC) analyzed cost of care for Coloradans across the state using data from 2012-2015. CIVHC found that cost of care varied by county, rural or urban setting, and gender for commercial, Medicare, and Medicaid payers. The report found that the leading cause of cost increases across all payers is attributed to an increase in pharmacy services.
 Consumers, Employers, Medicaid, Population Health, Researchers Commercial, Medicaid, Medicare