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A Solid Foundation Helps Meet a Health Data Challenge

Developing an information resource as complex as the Colorado All Payer Claims Database is a difficult and challenging undertaking. Although sophisticated technology is available, creating a functional database from complex claims information submitted by multiple payers and spanning several years is no easy task. The reality is that even the large and well established health payers face challenges in synthesizing and making sense of their own claims data.

The Colorado APCD is receiving millions of claims from Medicaid and multiple commercial payers, all of whom process and store information from multiple lines of business on different types of systems. Given these complexities, it was essential not only to determine what specific data elements were necessary, but also what to do when the required data was either missing or incomplete.

CIVHC has been able to face these challenges by building upon a strong foundation as well as the lessons learned and shared by APCDs across the country. The foundation for the Colorado APCD begins with flexible and visionary enabling legislation and generous financial support from The Colorado Trust and the Colorado Health Foundation. This has provided overall direction and a well-funded runway for building and growing the APCD into an important resource for Colorado.

CIVHC’s technology vendor, Treo Solutions, has years of experience developing large health information databases and understands that the ability to perform robust analyses of Colorado’s health care system begins with good data. Treo was selected, in part, based on their reputation for providing powerful reporting and analytic capabilities along with an unblemished record of success in protecting the privacy and security of sensitive health information. Treo also has a history of delivering reporting and analytic tools to support the needs of diverse stakeholder groups, strong financials, and a leadership team whose vision aligned with CIVHC’s focus on Triple Aim and transparency.

Throughout the process of building the database, CIVHC has worked closely with the payer community and conducted extensive stakeholder outreach to identify the APCD information and reporting priorities of groups working to change the health care system in Colorado. The results have helped us to plan for future updates to the APCD and identify specific information products that will be of value as we work toward achieving the Triple Aim of bending the cost curve, and improving health and the quality of health care for all Coloradans.

We are very pleased with the progress of Colorado’s APCD and are looking forward to its initial roll-out event on November 1st. This will represent a major milestone for a project that will build in richness and impact over a period of years and is a critical investment for Colorado. That said, big data projects like an APCD are complex and have a long development arc. CIVHC and its team do not take any of our work for granted and learn every day from the experiences of others across the country. We remain committed to the notion that providing transparent data on costs, quality and utilization of health care is vital for Colorado and we therefore continue to build on a solid foundation for a robust and sustainable APCD.

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About the Author: Jonathan Mathieu is CIVHC's Director of Data and Research. Contact him at  jmathieu@civhc.org.


 

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