Overview
The CO APCD contains millions of claims across all health plans for multiple years. Health insurance payers submit data monthly and the entire database is refreshed every other month, so the CO ACPD is continually evolving and being enhanced.
Data Warehouse Refresh Resources
The CO APCD Data Warehouse is refreshed every other month, incorporating new years of data while also improving the quality of the existing data by implementing new business rules, adding previously missing files, or correcting concerns. The breakdown of paid-through dates by business line for the most recent refresh is available here.
- View the paid through dates for the September refresh
- View the upcoming data warehouse refresh schedule
The Release Notes for the most recent refresh is now available for download and provides important information regarding the length of time between the service date and paid date (‘claims lag’) for medical and pharmacy claims in the CO APCD. This analysis helps answer several key questions including how long it takes to achieve “completeness,” how lag time varies by payer type (commercial, Medicaid, etc), and by claim type (medical, pharmacy, inpatient, outpatient, etc).
Query: CO APCD Data Quality
The Query: CO APCD Data Quality series is designed to:
- explain the foundations of how CIVHC approaches data quality as administrator of the CO APCD,
- detail the processes and systems that bring the data into the warehouse, and
- define what steps are taken before data is released.
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…
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…
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 contents of an output from the Colorado All Payer Claims Database (CO APCD). This piece will outline some baseline expectations for users who are new to claims Read more…
Pharmacy and Drug Rebate Data in the CO APCD
Previous queries have outlined that the CO APCD contains medical, dental, and pharmacy claims for the majority of insured individuals in Colorado. However, there are numerous other behind-the-scenes factors that provide insight into how an individual interacts with the health care system. One of the ways the CO APCD is Read more…
Behavioral Health and Substance Use Disorder Claims in the CO APCD
As of June 2023, the Colorado All Payer Claims Database (CO APCD) contained over 1 billion claims, representing over 5 million insured lives in Colorado, spanning from 2013-2022. Of these claims, there are over 65 million behavioral health claims contained in the CO APCD, representing over three million unique Coloradans Read more…
Race, Ethnicity, and Demographic Data in the CO APCD
Collecting reliable, standardized, high-quality data on race and ethnicity is a challenge most organizations working with health data across the country have grappled with for years, including administrators of All Payer Claims Databases (APCDs). However, all agree that this data is essential for to identifying health inequities across communities, gaining Read more…
In-Warehouse Quality Checks and Data Processing
Previous queries have detailed the process for the monthly submission and intake of claims data to the Colorado All Payer Claims Database (CO APCD). This query explores the steps the data undergo after being accepted into the warehouse. Once payer-submitted data has successfully passed the extensive initial validation and quality Read more…
Data Refreshes, Intake, and the SQI
Each month, health insurance payers submit millions of medical, professional, pharmacy, and dental claims for inclusion in the Colorado All Payer Claims Database (CO APCD). CIVHC along with data managers, Human Services Research Institute (HSRI) and NORC at the University of Chicago, continually work closely with submitters to ensure they Read more…
Phasegate
In fiscal year 2023-2024, CIVHC’s Data Operations team is implementing a new project management process, PhaseGate, to ensure projects moving through CIVHC’s teams are successful. The process divides development into distinct stages, or phases, separated by decision points, known as gates. The PhaseGate process is effective because it helps teams Read more…
Understanding Data Submission and the DSG
As administrator of the Colorado All Payer Claims Database (CO APCD), CIVHC is required by statute not only to maintain the database, but to continually improve the quality and utility of the CO APCD. One of the most essential activities to enhancing the CO APCD is annually updating the CO Read more…
Query: CO APCD Data Analytics
The Query: CO APCD Data Analytics series is designed to:
- provide insight into CIVHC's approach and philosophy of data analytics,
- outline the what is possible and what is not with the data, and
- demystify the process of CO APCD data release.
Limitations of CO APCD Data
With a resource the size of the Colorado All Payer Claims Database (CO APCD), it is easy to presume that the possibilities for exploration are endless. In some senses, it is true that comprehending the potential combinations of data elements from over one billion claims is nearly impossible. However, the scale of Read more…
Data Security and the CO APCD
When designing how the Colorado All Payer Claims Database (CO APCD) was to be built and administered, protecting health information was the highest priority. Colorado statute CRS 25.5-1-204 requires the CO APCD to “[p]rotect patient privacy in compliance with state and federal medical privacy laws while preserving the ability to analyze data Read more…
Rules Governing CO APCD Data Use
In 2010, the Colorado General Assembly saw the opportunities an immense repository of data such as the Colorado All Payer Claims Database (CO APCD) could afford – they also saw the possibilities for exploitation and built safeguards into the use of the CO APCD. When drafting the legislation that shaped the database, Read more…
Geocoding the CO APCD and Health Equity Analytics
It is estimated that 80% of a person’s health outcomes are related to social factors outside of their control. These social determinants of health are the nonmedical factors that influence a person’s health, including the conditions in which they are born, live, work, and age. In 2021, CIVHC took a big step to enhance the Read more…
Public Data Releases
As discussed in a previous Query, CIVHC releases data from the Colorado All Payer Claims Database (CO APCD) in two ways: Non-public releases, for individuals or organizations to use to improve care for Coloradans Public data, for anyone to use to help make data-driven health decisions A different query addressed Read more…
Data Element Request Form
Once someone has decided to use a non-public data set from the Colorado All Payer Claims Database (CO APCD), it is crucial that they request the right information to answer their questions. While that sounds like a relatively straight-forward determination, in many cases it is not. The Data Element Request Form, Read more…
Non-Public Release Application and Data Use Agreement
As discussed in a previous Query, individuals or organizations can request non-public data releases from the Colorado All Payer Claims Database (CO APCD) to help answer questions or solve particular problems around health care in Colorado. Today, we continue exploring the steps requestors must take to apply for a release Read more…
HIPAA & Personal Health Information
Protecting health information is the highest priority for the Colorado All Payer Claims Database (CO APCD). Colorado statute CRS 25.5-1-204 requires the CO APCD to “[p]rotect patient privacy in compliance with state and federal medical privacy laws while preserving the ability to analyze data and share with providers and payers to ensure Read more…
Contents of The CO APCD and How Data Is Released
The CO APCD is a state-legislated, secure health care claims database compliant with all federal privacy and antitrust laws. It is the only claims repository in the state that represents the vast majority of insured lives in Colorado, with more than ten years of data from commercial health insurance payers, Read more…
Specialized Analytics in Public Reporting
The Colorado All Payer Claims Database (CO APCD) contains medical, pharmacy, and dental claims from the majority of insured individuals in the state and collects non-claims data on additional components that impact individual health and cost of care. However, collecting all of this data is only the beginning for those Read more…