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 46 - 50 of 79

Use Cases Category Carriers
Medicaid Frostbite Claims with Amputation
The data reflects the number of claims with a frostbite diagnosis and subsequent amputation within 7 days of the initial frostbite diagnosis.
 Medicaid, Population Health, Researchers Medicaid
Coloradans with Pre-Existing Conditions
The data reflects the approximate number of Coloradans represented in the Colorado All Payer Claims Database (CO APCD) with a diagnosis of one or more of 10 common pre-existing conditions in 2016.
 Insurance Department, Medicaid, Population Health, Researchers Commercial, Medicaid
Data Byte: Top 25 CPTs by Volume in CO
Data reflects paid amounts and charges for the top 25 Professional Current Procedural Terminology (CPT) codes by volume in 2016, submitted through claims from 33 commercial payers to the Colorado All Payer Claims Database (CO APCD). This analysis includes both in and out-of-network payments (approximately 95% of payments are in-network in Colorado), and includes CPTs with and without modifiers.
 Insurance Department, Researchers Commercial
Colorado Data Byte: Emergency Department Facility Price Data
This Data Byte analyzes payment information from the CO APCD focused on how much commercial health insurance payers and patients pay for the Evaluation and Management(E&M) facility portion of an Emergency Department(ED) visit.
 Consumers, Insurance Department, Population Health, Researchers Commercial
Emergency Department Use for Mental Health Reasons in Colorado
The Emergency Department (ED) Mental Health-Related report provides stakeholders the opportunity to compare utilization and cost metrics for ED visits with a primary diagnosis of mental health among Medicaid, Medicare Advantage and Commercial payer eligible populations for Division of Insurance regions and Colorado as a whole.
 Consumers, Employers, Health Reform, Insurance Department, Medicaid, Population Health, Providers, Researchers Commercial, Medicaid, Medicare