USE CASE: Total Cost of Care at End of Life in Colorado

Center For Improving Value In Health CareCenter for Improving Value in Health Care (CIVHC) is an objective, not-for-profit organization. Through services, health data, and analytics, CIVHC partners with Change Agents to drive towards the Triple Aim for all Coloradans. CIVHC believes that together we can alter the trajectory of health care and is privileged to serve those striving toward a better health system for us all.

Project Summary: CIVHC is using CO APCD data aligned with information from the Colorado Death Registry to understand and describe the costs associated with dying in Colorado. This project will provide unique insight into how costs are distributed in the last two years of life and what sort of services are utilized.

Benefit to Colorado: Health care services at the end of life are expensive and often do not contribute to quality of life (or even, in many cases, longevity). To date the only widely available information about costs and care at the end of life is based on Medicare Fee for Service. This project will allow us to compare costs and health care utilization across payers (Medicare FFS, Medicare Advantage, Commercial plans, Medicaid, and dually eligible individuals), and by primary disease. Findings from this project will allow researchers to identify not only what the average cost of the last two years of health care in Colorado, but also what services are provided, regardless of how patients are insured. This information will be used to inform consumers with chronic disease about expected costs and care intensity in the last years of life, to identify areas with high levels of recommended service patterns, to determine the cost benefit with identifiable palliative care services, and ultimately inform policy and treatment conversations.