What to Expect with Claims Data

A previous query defined the different nuances encompassed under the term “data quality” to help shed light on the myriad factors that can impact the output from the Colorado All Payer Claims Database (CO APCD). This piece will outline some baseline expectations for users who are new to claims data. Claims Data Read more

By Stephanie Spriggs, ago

Defining Data Quality in the CO APCD

Claims data is very different than other types of data typically encountered by actuaries, accountants, analysts, and researchers. If not prepared for the unique challenges it presents, it is easy to conclude that something is wrong with a data set. The phrase “data quality” is frequently used as a catch-all Read more

By Stephanie Spriggs, ago

Non-Claims Data in the CO APCD

Non-Claims Data in the CO APCD The Colorado All Payer Claims Database (CO APCD) contains medical, dental, vision, and pharmacy claims from the majority of insured individuals in the state. However, claims data highlights only a portion of how the health care system functions. There are numerous other non-claims components Read more

By CIVHC, ago

In-Warehouse Quality Checks and Data Processing

Once payer-submitted data has successfully passed the extensive initial validation and quality tests performed by CIVHC and data manager Human Services Research Institute (HSRI) and NORC at the University of Chicago, the data are ready to be ingested into the warehouse. Previous queries have detailed the process for the monthly submission and intake Read more

By Sarah Ford, ago
Line chart illustrating the number of Medicare Advantage payers included in the Colorado All Payer Claims Database (CO APCD) from 2013 to 2023. The chart shows a starting count of 10 payers in 2013, a dip to 9 in 2014, followed by an increase to 12 payers in 2020 and 2022, before declining to 10 payers again in 2023. This visual highlights changes in Medicare Advantage payer participation over the years.

Medicare Data in the CO APCD

As of June 2023, the Colorado All Payer Claims Database (CO APCD) contained over one billion claims spanning 2013 through 2022. These claims were submitted by commercial health insurance plans, including Medicare Advantage, voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Medicare Fee-for-Service (FFS). The CO Read more

By CIVHC, ago

Commercial Data in the CO APCD

The Colorado All Payer Claims Database (CO APCD) contains over 1.1 billion claims, with more added every month. These claims are submitted by commercial health insurance plans, including Medicare Advantage, voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Medicare Fee-for-Service (FFS). The CO APCD Read more

By Stephanie Spriggs, ago

Medicaid Data in the CO APCD

The Colorado All Payer Claims Database (CO APCD) contains over 1.1 billion claims, with more added every month. These claims are submitted by commercial health insurance plans, including Medicare Advantage, voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Medicare Fee-for-Service (FFS). The CO APCD Read more

By Stephanie Spriggs, ago