Center for Improving Value in Health Care
Nov 18, 2015 | 0 comments | Posted by Global Administrator
Price Transparency, Colorado All Payer Claims Database
Thanksgiving is rapidly approaching which brings to mind all the things I’m grateful for - including some amazing family recipes. Each ingredient on its own is unique and important, but when you put them together it can be downright magical. We talk a lot about the power of organizational collaboration in Colorado in the same vein, but the same can be true when combining data sources.
Colorado comes from a position of strength when it comes to access to health care data. Multiple public sources exist thanks to forward thinking leaders across government agencies, foundations and organizations. Each source of information is great on its own, but what if we did more to deliberately combine these sources?
As one small example, CIVHC recently released a cost driver spot analysis estimating Colorado could save over $800 million per year by reducing Emergency Department (ED) visits for non-urgent conditions like colds and back pain. We used paid amounts from claims in the Colorado All Payer Claims Database to determine Coloradans could save $1150 on average per visit by using an outpatient setting versus an ED. Then we turned to the Colorado Hospital Association’s Databank and the Colorado Health Institute’s Colorado Health Access Survey to figure out how many ED visits occur annually, and of those, what percentage may have been avoidable. And, viola! With those three ingredients, we were able to identify over $800 million in savings!
That one example is just the tip of the iceberg for what we can do with Colorado’s health data resources. Work is already underway to combine the APCD data with clinical information to support national initiatives playing out in Colorado including the State Innovation Model, Transforming Clinical Practice Initiative and the Comprehensive Primary Care Initiative. Several organizations in the state have received custom data from the APCD to begin combining claims data with clinical information. We’re also having discussions with behavioral health, public health and organizations addressing the social determinants of health to find ways of merging those important data sources to get a more complete picture of health care in Colorado.
On a more national scale, at the beginning of this year I participated in the Health Data Leadership Summit hosted by the Health Data Consortium (HDC), to brainstorm how Colorado and the nation could advance open data sources. The approximate 30 attendees represented diverse constituencies and interests including the federal government, non-profit organizations, payers, consultants, foundations, providers, vendors and researchers. The purpose of the Summit was to have a thoughtful dialogue about the health, public policy and technology trends impacting data accessibility, to generate a shared vision of success in data accessibility, and to develop strategies or action plans to overcome some of the obstacles associated with the shared vision of data accessibility.
As reported by HDC, participants at the summit identified a number of barriers that impede the shared vision of data accessibility. However, the group focused on six key barriers which, if addressed, would have the largest impact on achieving the shared vision and be easy to tackle through collective stakeholder action. The barriers identified by attendees included: (1) lack of standardized standards, (2) excessive compliance and confusion with HIPAA, (3) failure to articulate the value proposition associated with data accessibility, (4) the current fee for service payment model, (5) insufficient quality measures and (6) failure to articulate and prioritize data accessibility objectives and goals. Findings and recommendations were proposed by attendees that would help eliminate these barriers and achieve the shared vision.
CIVHC, likewise, believes that a shared vision of success in data accessibility is possible. We believe that the key to greater value and accessibility is through partnering with the many different data sources to help identify root causes and opportunities for improvements as well as set the path for achievement of the Triple Aim.
This diagram demonstrates CIVHC’s vision in conjunction with partnerships throughout the state to ultimately combine data from across claims, clinical, patient safety, surveys, social determinants information and more.
If we can get to this point in Colorado, the result could be incredible and could provide even more extensive access to meaningful, actionable data to drive change.
A recipe for success.
About the Author: Ana English is CIVHC's President and CEO. Contact her at firstname.lastname@example.org.
Share on: Digg, Facebook, Reddit, Delicious, Twitter
© Copyright. Center for Improving Value in Health Care. All rights reserved.
950 S. Cherry Street, Suite 208, Denver, Colorado 80246 | 720-583-2095 (main phone) | 720-549-9189 (fax) | contact us