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Data and Quality Measures Essential for Better Health Care

by Ned Calonge, MD, originally published in Health Policy Solutions November 2, 2012

This week we saw the first presentation of the Colorado All Payer Claims Database, a project of the Center for Improving Value in Health Care (CIVHC) that is jointly funded by the Colorado Health Foundation and The Colorado Trust.

We at The Trust believe that the claims and costs data collected through the APCD, as well as specific measures of quality, will provide an essential missing part of the spectrum of data needed to inform health care decisions by business leaders, policymakers, providers, payers and, of course, health care consumers.

The Affordable Care Act goes a long way in addressing coverage for uninsured Coloradans. However, we must ultimately address the cost of health care for any reform to succeed. We know from our Colorado Health Access Survey, or CHAS, that the number one reason people don’t have health insurance is affordability. Clearly, it’s impossible to fully address the problem of affordability without cost data, and the APCD fills this critical need. It is an important part of the puzzle in helping to achieve access to health for all Coloradans – the vision of The Colorado Trust.

I’m excited about the possibilities of claims data in completing the picture of health and health care in Colorado – particularly for those who are most underserved and most vulnerable. The APCD will allow us to combine cost and utilization data with data on the health care workforce, health care access, mortality, disease incidence and location, creating a more comprehensive information resource.

Claims data will introduce key information to support market competition, giving patients and insurers comparative data on which to base decisions. The information will also support performance improvement by health care providers and facilities. We will need to work together to vet the data, understand causes of variations and propose solutions that reduce costs and improve quality of care.

Putting together a database like this is an enormous undertaking, and we applaud CIVHC’s progress to date. CIVHC’s translation of huge amounts data into useful information, as you can see on their website, is impressive, especially recognizing the complexity of standardizing and joining multiple disparate data sources from several different sources.

What we need to remember is that these data – this incredibly complex, robust listing of numbers and information – tell us stories about people. Far too many of these individuals and families who are Colorado, unnecessarily suffer poor health because they cannot afford health insurance or perhaps because they don’t know where to turn for health care services. Our support for the APCD is aimed specifically at improving the health of Coloradans by informing ongoing efforts to greatly strengthen the ability for more accessible health care across the state.

Ned Calonge, MD, serves as President and CEO of The Colorado Trust. Prior to joining The Colorado Trust in 2010, Dr. Calonge served as the Chief Medical Officer of the Colorado Department of Public Health and Environment. He also served as the Chief of the Department of Preventive Medicine for the Colorado Permanente Medical Group and was a family physician for 10 years. He has chaired and served on numerous boards and commissions, authored more than 80 articles and is board certified in both Family Medicine and Preventive Medicine. He was elected to the Institute of Medicine in 2011.

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Jonathan Mathieu
The All Payer Claims Database (APCD) Total Cost of Care (TCC) figures and health plan premium increases from the Lockton survey are based on two different data sources which currently aren’t directly comparable. The APCD TCC represents average total cost of care for individuals in a geographic region based on claims data from Medicaid and the eight largest commercial payers (individual, large group fully-insured and some self-insured lives). The Lockton Survey shows employer self-reported premium increases for commercial plans only. The APCD claims data supporting the TCC calculations is currently weighted heavily towards Medicaid (60% Medicaid, 40% commercial) making it potentially misleading to directly compare APCD cost trends to commercial health plan premium trends. As the APCD data grows and more commercial payers are added to the database, more direct comparisons between total cost of care and health premiums will be possible.
11/19/2012 2:50:53 PM

David L. Roper
I'm very interested in all sources of health costs and quality data, which seems to be difficult to come by. I'm also curious as to why APCD 2009-2011 "Total Cost of Care" data shows no inflationary increase for Colorado, when Lockton and other survey data shows annual increases of 5-10% over the period.
11/15/2012 10:54:00 AM

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