Center for Improving Value in Health Care
Feb 13, 2015 | 0 comments | Posted by Global Administrator
Colorado All Payer Claims Database, Consumer Engagement, Price Transparency, Triple Aim, Care Transitions
Over the last two years, the Colorado APCD team has worked very hard with stakeholders across the state of Colorado, as well as across the country, to make the state’s most comprehensive health care claims database accessible and valuable for the benefit of Coloradans. According to the legislation establishing the database, the purpose of the CO APCD is to “facilitate the reporting of health care and health quality data that results in transparent and public reporting of safety, quality, cost and efficiency information at all levels of health care.” We’ve come a long way towards realizing that public purpose from 2012 to now and I’d like to highlight some of the exciting ways organizations are using the custom data for health care improvement.
The publicly available data on www.comedprice.org has been instrumental in identifying variation in cost and utilization as well as giving consumers the chance to shop for specific health care procedures across the state for the first time. We’re thrilled to be one of the few APCDs in the nation that provides custom data reports in addition to public reports. These reports inform and support strategic initiatives advancing the Triple Aim of better health, better care and lower costs. In fact, we’ve fulfilled such a wide variety of data requests for innovative purposes that we developed a success gallery highlighting the projects that have been supported by APCD custom reports.
Claims data in the APCD can be sliced and diced in thousands of different ways, and it’s challenging for most organizations to understand all of the ways the APCD can benefit their improvement work. The development of the success gallery is an important tool to demonstrate how people might use this important public resource. The table below summarizes the wide variety of projects that have been supported by APCD data and the type of organization that requested the information.
Ways CO APCD Data is Being Used to Inform and Advance the Triple Aim
Colorado All Payer Claims Database Data Request Projects (Updated January 2015)
Type of Entity
Health Care Stakeholder Organizations
o Testing Bundled Care Analytics to Improve Care and Lower Costs
o Combining Electronic Medical Records with Claims Data to Identify Opportunities for Improving Outcomes for Medicaid Patients
o Analyzing Hospital Bundled Payment Opportunities
o Determining Insurance and Provider Composition Across Colorado
o Analyzing Inflammatory Bowel Disease Treatments and Medications to Identify Best Practices
o Developing Bundled Payments for Palliative Care in Colorado
o Assessing the Impact of Cost-Sharing Policy Changes on the Use of Preventive Services
o Identifying Hospital Pricing for Uninsured
o Studying Impact/ROI of Home-Delivered Meals on Care Transitions
o Analyzing ED visits for non-traumatic dental services in Colorado
o Assisting Family Planning Centers with Setting Rates
o Evaluating vaccines claims data to assess the completeness of the Colorado Immunization Information System (CIIS)
o Analyzing loss data by geographic area to determine appropriate geographic rating areas for Colorado
o Analyzing insurance claim trends to determine appropriateness of proposed health insurance rates
o Developing Prior Coverage Analysis
Health Care Providers
o Developing Bundled Payments for Orthopedic Care
o Developing Innovative 21st Century Ambulatory Health Care Model
o Evaluating Cost of Care to Move Towards Value-Based Economic Model
o Analyzing Health Plan Rates in Rural Areas
o Identifying Opportunities to Reduce Use of Potentially Harmful Medications During and Post Surgery
o Analyzing Disease-specific Treatment Cost and Utilization
o Evaluating Availability and Cost for Optometrist Services to Enhance Access for Medicaid Patients
o Informing Rate Setting and Provide Network Development
o Analyzing Bundled Payments for Health Plans
In our second year of fulfilling data and custom report requests, we quadrupled the number of organizations that received data. This considerable growth has enabled us to establish important relationships with state agencies, researchers, and nonprofits as well as others focused on health and health care. On our showcase, you can see the three main categories that the majority of projects fall into: Health Coverage/Rate Setting, Outcome/Cost Improvement, and Payment Reform/Bundled Payments. You can then dive deeper into each project to understand the types of data they received and the goals of their projects. For example, Project Angel Heart is highlighted below for their project seeking to determine a return on investment for their meal delivery services.
Project Angel Heart intends to use the analysis to demonstrate the value their organization provides by supporting care transitions work and keeping patients healthy. Their project is funded through the HCPF Scholarship Fund which is available for non-profits, researchers and state agencies through June of 2015. Click here for more information.
As you think about the mission and vision of your own organization, we hope you will look to the Colorado APCD for help and support in reaching your goals. We now have 20 commercial health plans submitting data each month for the individual, small group, and large group markets in addition to Medicaid, Medicare and Medicare Advantage data. The APCD is trusted, objective health information on services, utilization, quality, and prices that have been rendered in Colorado. Take a look at our showcase and let your imagination take flight. When you have a great idea (or a few) to put into reality, please contact us at: firstname.lastname@example.org.
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