Center for Improving Value in Health Care
Oct 21, 2014 | 0 comments | Posted by Cari Frank
Health Reform, Price Transparency, All Payer Claims Database
Similar to the saying, “the early bird gets the worm”, initial Colorado organizations who have applied for the APCD Scholarship awards are “the early requestors getting the data!” Three organizations have applied for and received a scholarship award for APCD data. This group of innovative organizations are focused on one or more aspect of the Triple Aim. They are using the data to improve decision-making for consumers, look at the efficacy of Accountable Care Act (ACA), and to conduct condition-based research to improve care.
One organization is a consumer advocacy group focused on achieving barrier-free access to quality and affordable health care for all Coloradans. Senate Bill 134 requires hospitals to limit charges to low income, uninsured patients to the lowest negotiated rate they have with commercial payers. This organization intends to use APCD data to provide Coloradans who meet the low income, uninsured threshold with lowest price median estimates for hospital-based health care services. While the APCD data does not contain contractual arrangements between payers and facilities, it can provide median paid amounts based on 150 million claims. This organization’s goal is to establish a baseline price for procedures at individual hospitals so that consumers can have a better understanding of prices before procedures and evaluate their options.
The second organization receiving funding is analyzing the impact of the federal ACA laws. One part of the law required insurance companies to provide their members with free preventive services. This organization wants to evaluate whether patients have started taking advantage of this new benefit and whether there has been an increase in preventive services. The APCD database is providing a baseline for the utilization of preventive services prior to the ACA going into effect and identifying whether there was an increase or decrease in these services after ACA implementation. With claims from 2009-2014, pre and post analysis is a great way to leverage the power of the APCD data.
The third scholarship awardee is studying the impact of pain medications prescribed post-surgery for acute pain. While the use of illegal drugs contributes to the number of individuals who die from overdosing, the number of individuals who die from prescription overdose is higher. The organization is evaluating prescription patterns after surgery over a multi-month period to research patient safety and the use of drugs post-surgery.
We’re thrilled to see the APCD data and the scholarship fund being used for health care improvement in Colorado.
Funding is available on a first come, first serve basis through June 30, 2015 (or until funds are depleted) and we would love to help your organization leverage the APCD to advance the Triple Aim. Here are some other questions the APCD scholarship fund and APCD claims data can be help answer:
State agencies, non-profits and researchers with annual budgets of less than $5 million per year are eligible for funds to help offset the cost of data and reports. We are happy to work with your organization to answer any questions you may have and help you identify how claims data can inform your work. We have a team of experienced health care specialists ready to assist you in getting access to Colorado’s most comprehensive resource of cost, utilization, and quality health care claims data.
To take advantage of the scholarship opportunity, click here to learn more or contact us directly at: ColoradoAPCD@civhc.org.
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